Terbinafine

Terbinofine*
• eg Lamosil® - both oral and topical
• allyamine derivative
• inhibits squalene epoxidase  inhibits ergosterol synthesis
• contraindications – liver or renal disease
• major side effects: liver toxicity; severe neutropenia; agranulocytosis, pancytopenia, anaphylaxis, eye changes.
• maybe liver function tests if at risk for monitoring if used > 6 weeks
• interactions – lowers cyclosporine levels
• onychomycosis dosage – 250/mg/day for 12 weeks for toenails

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