Terbinafine (Oral)

As an antifungal medicine, terbinafine works to stop the growth of fungi and treat a variety of fungal infections.

Overview

Terbinafine belongs to the category of drugs known as antifungals, and is available in granule and tablet form. Terbinafine granules are used for treating fungal infections of the scalp, while the tablets are used to treat fungal infections of the fingernails and toenails. This medication is sometimes also prescribed to treat jock itch (a fungal infection of the skin in the buttocks or groin), and ringworm (skin fungal infections characterized by a red, scaly rash that may appear on different parts of the body). Terbinafine is only available with a doctor's prescription.

Conditions treated

  • Fungal infections

Type of medicine

  • Antifungal

Side effects

Besides the desired effects, terbinafine may be responsible for certain unwanted effects. Immediately check with your doctor if you experience any of these side effects:

More common:

  • Fever

Less common:

  • Chills
  • Body aches/pain
  • Cough
  • Sore throat
  • Difficulty breathing
  • Diarrhea
  • General feeling of illness
  • Headache
  • Ear congestion
  • Loss of voice
  • Joint pain
  • Loss of voice
  • Loss of appetite
  • Trouble sleeping
  • Runny nose
  • Nasal congestion
  • Sneezing
  • Shivering
  • Sweating
  • Skin rash or itching
  • Nausea
  • Vomiting
  • Upper abdominal/stomach pain
  • Unusual weakness or tiredness
  • Rare
  • Stomach pain
  • Dark urine
  • Pale stools
  • Pale skin
  • Difficulty swallowing
  • Yellow eyes or skin
  • Redness, loosening, peeling, or blistering, of the skin
  • Unusual bleeding/bruising

Incidence not known:

  • Bloating
  • Constipation
  • Black, tarry stools
  • Pain in the chest
  • Dizziness
  • Bleeding gums
  • Blood in the stools or urine
  • Fast heartbeat
  • Hair loss
  • High fever
  • Cough/hoarseness
  • Flu-like symptoms
  • Indigestion
  • Hives
  • Lower back or side pain
  • General feeling of lethargy or weakness
  • Feeling of discomfort
  • Inflammation of joints
  • Swelling (large and hive-like) on the face, throat, lips, tongue, eyelids, hands, feet, legs, or sexual organs
  • Pale stools
  • Muscle aches
  • Difficult or painful urination
  • Pain in the abdomen, stomach, or side, possibly spreading to the back
  • Continual loss of appetite
  • Stomach pain, continuing
  • Red skin lesions, typically with a purple center
  • Red, crusted or scaling skin
  • Red spots on skin
  • Blisters, sores or welting
  • Sores, ulcers or white spots in mouth
  • Unexplained bruising or bleeding
  • Itching
  • Hives or welts
  • Chest tightness
  • Rash
  • Irritation
  • Troubled breathing
  • Swollen lymph glands
  • Swollen glands
  • Swelling/puffiness of eyelids or area around the eyes
  • Swelling/puffiness of lips, face, or tongue
  • Red, irritated eyes

Some of the side effects of terbinafine may not require medical attention. These side effects may vanish as your body adjusts to the medication. Your pharmacist or doctor may advise you on what to do to minimize the chances of these side effects. Check with your health care giver if the following side effects become bothersome or persist:

More common:

  • Mild stomach pain

Less common:

  • Heartburn
  • Acidic or sour stomach
  • Toothache
  • Unpleasant or unusual (after) taste
  • Belching
  • Change or loss of taste

Incidence not known:

  • Decreased vision
  • Irritability
  • Feeling empty or sad
  • Discouragement
  • Loss of sense of smell
  • Loss of pleasure or interest
  • Muscle spasms/cramps
  • Tiredness
  • Difficulty with moving
  • Loss of appetite
  • Muscle stiffness
  • Trouble concentrating

This is not necessarily a comprehensive list of all the possible side effects. If you experience any other effects not listed here, check with your doctor as soon as possible.

Dosage

Your dosage and length of treatment will depend on the condition for which you are being treated. Take your medication exactly as your doctor prescribed. This medication also comes with a medication guide and instructions for the patient. Be sure to read the instructions carefully and follow them.

You may take terbinafine tablets with food or on an empty stomach. Terbinafine oral granules are however best taken with food. The medication works best when a constant amount is maintained in the blood. To ensure the amount remains constant, do not skip or miss any doses. It is also important that you take your doses at the same times each day.

To completely clear your infection, it is vital that you keep taking this medication for the full duration of treatment, even if you begin to feel better or your symptoms start to clear up after a short while. Because fungal infections typically take long to clear up, you may have to use this medication for several weeks or months. Symptoms may return if you stop taking the medication too soon.

Missed dose:

If you miss a dose, take it the moment you remember. However, you may go back to the regular schedule if you are close to the next scheduled dose. Do not make up for a missed dose by taking an extra dose.

Overdose:

Symptoms of overdose may include: headache, rash, abdominal pain, dizziness, nausea, vomiting and frequent urination. If you suspect an overdose, call your nearest poison control center at 1-800-222-1222 (US Residents).

Drug Interactions

Drug interactions can affect how the drug functions in your system, or increase the risk of serious side effects occurring. Using this medication together with any of the following is usually not recommended, but may sometimes be necessary. If both medications are prescribed together, your doctor could change the dose or frequency of taking one or both medications.

  • Eliglustat
  • Nebivolol
  • Fluoxetine
  • Brexpiprazole
  • Donepezil
  • Doxorubicin Hydrochloride Liposome
  • Doxorubicin
  • Metoprolol
  • Clozapine

Other medical conditions:

Having other medical conditions could affect the use of terbinafine. Be sure to inform your doctor if you are suffering from or have a history of these medical conditions:

  • Systemic lupus erythematosus (SLE)
  • Blood problems, such as neutropenia
  • Weakened immunity - use with caution; aggravate conditions
  • Liver disease (chronic or active) - not to be used by patients with this condition.

Warnings

This medicine may cause your skin to become more sunlight-sensitive. Avoid the sun, tanning beds and sunlamps. Use sunscreen and put on clothing that keeps you protected from the sun.

Avoid caffeine (tea, chocolate, coffee, cola) while taking this medication. Using this medicine with caffeine will cause the caffeine to stay longer in your system, and may cause a fast heartbeat, shakiness, and nervousness.

This medication has been reported to cause serious liver problems in some patients, including liver failure. Notify your doctor immediately if you have these symptoms: nausea or vomiting, pale stools, stomach pain, dark urine, or yellowing of skin or eyes.

This medicine could affect your sense of taste or smell. Inform your doctor right away if you or your child experience changes in taste or loss of taste, changes or a loss of sense of smell, poor appetite, and weight loss.
Taking this medicine has been reported to cause depression in some patients. Immediately notify your doctor if you or your child believes the medicine is causing changes in behavior or mood. Other symptoms may include: feeling very empty or sad, feeling irritable, restlessness, loss of appetite, loss of interest or pleasure, trouble sleeping, or trouble concentrating.

This medication may temporarily reduce the number of white blood cells in the blood, thereby increasing the risk of getting an infection. Avoid getting close to people with infections if you can. Check with your doctor if you suspect you are getting an infection or if you get a fever or chills, lower back or side pain, cough or hoarseness, or difficult or painful urination.

This medication may trigger a severe allergic reaction known as anaphylaxis, which could be life-threatening and will thus require emergency medical attention. Get medical help if you notice any of these symptoms: dizziness or lightheadedness, chest pain, itching, rash, hives, swollen face, mouth or hands, difficulty with swallowing, difficulty with breathing after taking the medication.

Tell your doctor if you are pregnant or plan to become pregnant. Your doctor will help you weigh the risks against the benefits of taking the medicine while pregnant. It has not yet been established if this medication is passed through breast milk. Nursing mothers should consider the potential benefits against the risks of using terbinafine while breastfeeding.

Storage

Terbinafine should be stored at room temperature. Keep the medication firmly sealed in its original container, in a dry place that is out of reach of children. Do not store the container in the bathroom. Talk to your pharmacist about how to dispose of any unused medicine.

Summary

Terbinafine is an antifungal medicine prescribed for treating fungal or yeast infects in the toenails, fingernails, scalp, groin and other parts of the body. This medication is usually prescribed for several weeks or months, as fungal infections can be slow to clear. It is important that you take your medication for the full prescribed period to avoid re-infection. Be sure to take the medication as prescribed by your doctor.

This medication comes with a number of serious risks and side effects you should be aware of, including serious kidney problems, severe allergic reactions, loss of sense of taste and smell, depression, sunburn due to skin sensitivity, and a weakened immune system, which increases the risk of various infection. Before starting treatment with terbinafine, have a discussion with your doctor about these risks. Do not hesitate to call your doctor if you experience any severe side effects after taking the medication.

Resources
Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
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