Terbinafine

Background

• Allylamine antifungal
• Inhibits ergosterol synthesis by inhibiting squalene epoxidase

Dosing

Topical

• Tinea pedis
  • Terbinafine cream applied to affected areas twice daily for at least one week
  • Terbinafine gel applied to affected area once daily at bedtime for at least 1 week
  • Terbinafine spray applied to affected area once daily for at least one week
• Tinea corporis and tinea cruris: as above

Systemic

• Onychomycosis
  • Continuous dosing: 250 mg PO once daily for 6 weeks (fingernails) or 12 weeks (toenails)
  • Pulsed dosing: 250 mg PO once daily for 4 weeks, off for 4 weeks, then resume for 4 weeks
  • Pulsed dosing: 250 mg PO once daily for 1 week repeated every 4 weeks for 3 months
• Sporotrichosis: 500 mg PO BID, continued for 2 to 4 weeks after resolution of all lesions (usual duration 3 to 6 months)