Terfix
Generic Name
Terbinafine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| terfix 250 mg tablet | ৳ 40.00 | ৳ 400.00 |
Description
Overview of the medicine
Terfix (Terbinafine) is an antifungal medication used to treat various fungal infections of the skin, hair, and nails, including dermatophytosis and onychomycosis.
Uses & Indications
Dosage
Adults
Onychomycosis: 250 mg once daily for 6 weeks (fingernails) or 12 weeks (toenails). Tinea corporis/cruris/pedis: 250 mg once daily for 2-4 weeks. Tinea capitis: 250 mg once daily for 4-6 weeks (children's dose varies by weight).
Elderly
No evidence suggests a need for different dosages in the elderly; however, caution is advised if hepatic or renal impairment is present.
Renal_impairment
Not recommended in patients with creatinine clearance < 50 mL/min or severe renal impairment. In moderate renal impairment, consider dose reduction.
How to Take
Terfix tablets should be taken orally once daily with or without food. Complete the full course of treatment as prescribed, even if symptoms improve.
Mechanism of Action
Terbinafine inhibits fungal squalene epoxidase, an enzyme involved in fungal sterol biosynthesis. This leads to an accumulation of squalene within the fungal cell and a deficiency of ergosterol, resulting in fungal cell death.
Pharmacokinetics
Onset
Clinical improvement typically seen within a few weeks, full effect for nail infections may take months.
Excretion
Primarily excreted in urine (70-75%) and feces (20-25%).
Half life
Terminal half-life is approximately 17-36 hours.
Absorption
Well absorbed orally (>70%), high first-pass metabolism.
Metabolism
Extensively metabolized by at least seven CYP isoenzymes (CYP2C9, CYP1A2, CYP3A4, CYP2C8, CYP2C19, CYP2D6, CYP2B6) to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to terbinafine or any component of the formulation
- Chronic or active liver disease
Drug Interactions
Warfarin
Rare reports of changes in INR with concomitant use; monitor INR closely.
Cimetidine
May decrease terbinafine clearance, increasing its plasma levels.
Rifampicin
May increase terbinafine clearance, decreasing its plasma levels.
SSRIs/MAOIs/Beta-blockers
Terbinafine is a CYP2D6 inhibitor and may increase the plasma levels of drugs metabolized by this enzyme.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include headache, nausea, epigastric pain, and dizziness. Management is symptomatic and supportive. Gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category B. Use in pregnancy only if clearly needed. Terbinafine is excreted in breast milk; therefore, it should not be used by nursing mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, specific to the batch.
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA, Bangladesh
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Terbinafine has undergone extensive clinical trials demonstrating its efficacy and safety in treating various fungal infections, particularly onychomycosis and dermatophytosis. Studies have confirmed its fungicidal activity and favorable cure rates.
Lab Monitoring
- Liver function tests (LFTs) should be performed before initiating oral terbinafine therapy and periodically during treatment (e.g., at 4-6 weeks), especially in patients with pre-existing liver conditions.
- Complete blood count (CBC) in patients at risk of hematological disorders.
Doctor Notes
- Counsel patients on the importance of completing the full course of therapy to prevent recurrence and resistance.
- Emphasize immediate reporting of signs/symptoms of hepatotoxicity.
- Consider drug interactions, especially with CYP2D6 substrates, and adjust doses if necessary.
Patient Guidelines
- Take the medication exactly as prescribed and complete the full course of treatment, even if symptoms improve.
- Report any signs of liver problems (e.g., persistent nausea, loss of appetite, dark urine, yellowing skin/eyes, unusual tiredness) to your doctor immediately.
- Avoid excessive sun exposure and use sunscreen, as terbinafine can increase photosensitivity.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Terbinafine is generally not expected to affect the ability to drive or operate machinery. However, if you experience dizziness or visual disturbances, avoid such activities.
Lifestyle Advice
- Maintain good foot hygiene for tinea pedis, including keeping feet dry and wearing breathable footwear.
- Avoid sharing personal items like towels, socks, and shoes to prevent the spread of fungal infections.
- For nail infections, regularly trim nails and ensure proper ventilation.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.