Tinafin
Generic Name
Terbinafine
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tinafin 250 mg tablet | ৳ 50.00 | ৳ 300.00 |
Description
Overview of the medicine
Terbinafine is an allylamine antifungal used to treat fungal infections of the skin, hair, and nails caused by dermatophytes.
Uses & Indications
Dosage
Adults
250 mg once daily. Duration typically 6-12 weeks for onychomycosis, 2-6 weeks for skin infections.
Elderly
No specific dose adjustment required, but caution in pre-existing liver or renal impairment.
Renal_impairment
Reduce dose to 125 mg daily if creatinine clearance is less than 50 mL/min.
How to Take
Take orally with or without food. It is recommended to take it at the same time each day.
Mechanism of Action
It inhibits ergosterol synthesis by blocking squalene epoxidase, leading to squalene accumulation within the fungal cell and causing cell death.
Pharmacokinetics
Onset
Clinical improvement observed within weeks; complete cure for onychomycosis may take several months.
Excretion
Primarily via urine (70-80%) as metabolites, with some excretion via feces.
Half life
Terminal elimination half-life is approximately 200-400 hours; distribution half-life is about 17 hours.
Absorption
Well absorbed from the gastrointestinal tract (>70%). Bioavailability is approximately 40% due to first-pass metabolism.
Metabolism
Extensively metabolized in the liver by at least seven CYP isoenzymes (mainly CYP2C9, CYP1A2, CYP3A4, CYP2C8, and CYP2D6).
Side Effects
Contraindications
- Hypersensitivity to terbinafine or any of its excipients.
- Chronic or active liver disease.
- Severe renal impairment (creatinine clearance < 50 mL/min) without dose adjustment.
Drug Interactions
Caffeine
Terbinafine may decrease the clearance of caffeine.
Cimetidine
May decrease terbinafine clearance, increasing its concentration.
Rifampicin
May increase terbinafine clearance, decreasing its concentration.
Tricyclic Antidepressants (e.g., desipramine)
Terbinafine may inhibit the metabolism of drugs metabolized by CYP2D6.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include headache, nausea, epigastric pain, and dizziness. Management involves gastric lavage, activated charcoal, and symptomatic supportive treatment.
Pregnancy & Lactation
Not recommended during pregnancy unless the potential benefits outweigh the risks. Avoid during breastfeeding as terbinafine is excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to terbinafine or any of its excipients.
- Chronic or active liver disease.
- Severe renal impairment (creatinine clearance < 50 mL/min) without dose adjustment.
Drug Interactions
Caffeine
Terbinafine may decrease the clearance of caffeine.
Cimetidine
May decrease terbinafine clearance, increasing its concentration.
Rifampicin
May increase terbinafine clearance, decreasing its concentration.
Tricyclic Antidepressants (e.g., desipramine)
Terbinafine may inhibit the metabolism of drugs metabolized by CYP2D6.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include headache, nausea, epigastric pain, and dizziness. Management involves gastric lavage, activated charcoal, and symptomatic supportive treatment.
Pregnancy & Lactation
Not recommended during pregnancy unless the potential benefits outweigh the risks. Avoid during breastfeeding as terbinafine is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date.
Availability
Pharmacies nationwide
Approval Status
Approved
Patent Status
Generic available
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of oral terbinafine for the treatment of dermatophyte infections, including onychomycosis, tinea corporis, tinea cruris, and tinea pedis.
Lab Monitoring
- Liver function tests (LFTs) should be performed before starting treatment.
- Periodic LFTs should be considered during prolonged therapy, especially in patients with pre-existing liver disease.
Doctor Notes
- Counsel patients thoroughly on the importance of completing the full treatment course and potential for hepatotoxicity.
- Emphasize the need to monitor for signs of liver dysfunction and advise immediate reporting of symptoms such as persistent nausea, dark urine, or jaundice.
- Consider baseline and periodic liver function tests for patients on prolonged therapy or those with risk factors.
Patient Guidelines
- Complete the full prescribed course of treatment, even if symptoms improve, to prevent relapse.
- Immediately report any signs of liver problems (e.g., persistent nausea, appetite loss, dark urine, yellowing of skin/eyes).
- Report any persistent taste disturbance, as it can be severe and prolonged.
Missed Dose Advice
If a dose is missed, take it as soon as remembered, unless it is almost time for the next scheduled dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Terbinafine may cause dizziness in some patients. Patients should be advised to exercise caution when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Maintain good personal hygiene, keeping affected areas clean and dry.
- Wear breathable footwear and cotton socks for foot infections to allow air circulation.
- Avoid sharing personal items like towels, combs, or shoes to prevent spreading the infection.
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Global Brand Names
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