Terbinafine brands and prices in Pakistan

About Terbinafine

Terbinafine is an antifungal medicine. It kills the fungus that causes an infection by making holes in the fungus's outer layer (cell membrane), so the inside leaks out. It comes as a cream, gel, spray or liquid (solution) to put on the skin, and as tablets to swallow. In the UK the skin products can be bought from a pharmacy or shop, but the tablets need a prescription and are used when a skin product is unlikely to work, such as for nail infections. WHO lists terbinafine cream and ointment as essential medicines for fungal skin infections, in adults and children.

Who should not take it, or should take care

• Do not use it if you have ever had an allergic reaction to terbinafine or any other ingredient.
• Tablets: do not take them if you have severe liver or kidney problems. Tell your doctor about any liver or kidney problems first.
• Tablets: tell your doctor if you have psoriasis, lupus (skin or whole-body), HIV or a weak immune system.
• Tablets: your doctor may arrange blood tests before and during treatment to check your liver.
• Pregnancy: the tablets are generally not recommended. There is no evidence that the cream, gel, spray or solution harm the baby, but speak to a doctor if you are pregnant or trying for a baby.
• Breastfeeding: advice differs. The UK tablet leaflet and MedlinePlus say not to breastfeed while taking the tablets, while NHS says only a very small amount passes into milk and a different antifungal may be suggested. With skin products, very little reaches the milk; do not put it on the breasts and keep the baby away from treated skin. Ask your doctor or pharmacist.
• Age limits depend on the product. NHS says a doctor can prescribe the tablets, cream and gel for children from age 1, while the UK tablet leaflet says the tablets are not recommended under 18. Products bought without a prescription are for older children and adults only, so check the pack.

Medicines and drinks that can interact

• Skin products (cream, gel, spray, solution) are generally fine to use with other medicines. Do not put other products on the treated area.
• Tablets: rifampicin (an antibiotic) can lower the amount of terbinafine in the blood, and cimetidine (a stomach medicine) can raise it
• Tablets: antidepressants
• Tablets: heart medicines such as beta blockers, amiodarone and propafenone
• Tablets: ciclosporin (used after an organ transplant)
• Tablets: warfarin (a blood thinner) and tamoxifen (a breast cancer medicine)
• Tablets: codeine may work less well, and tramadol may cause more side effects
• Tablets: dextromethorphan (a cough medicine) and other antifungals such as fluconazole and ketoconazole
• Tablets: the contraceptive pill. Terbinafine is not likely to stop it working, but some people get spotting or irregular bleeding; tell a doctor if this happens.
• Tablets: caffeine. The tablets can make the effects of coffee, tea, cola, energy drinks and chocolate stronger, so cut down on them.
• Paracetamol, ibuprofen, diclofenac and naproxen are safe to take with terbinafine.
• There is not enough information to show herbal remedies or supplements are safe with it; tell your pharmacist about any you take.

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Use the tablets only when a doctor prescribes them for you. Keep using any form for the full course you were told, even if the skin or nail looks better, so the infection does not come back. Talk to your doctor before stopping.
• For creams, gels and sprays: wash your hands before and after, and clean and dry the skin first, including between the toes. Use a thin layer on the infected skin and a little around it.
• In skin folds, such as between the toes or in the groin, a light gauze strip can be put over the treated skin.
• Swallow tablets whole with a drink of water. They can be taken with or without food.
• If you forget a dose, take it when you remember unless the next one is nearly due. Never take two doses together.
• Keep the skin clean and dry, avoid scratching, and do not share towels, bedding or combs. Wash bedding regularly.
• The tablets can make skin more sensitive to sunlight. Limit time in strong sun, avoid sunbeds and use sunscreen and protective clothing.
• Do not drive or cycle if you feel dizzy, tired or unwell.
• Do not give blood while taking terbinafine tablets, and wait for a while after finishing them; check with the blood service. Using a skin product does not stop you giving blood.
• Store out of the reach of children, in the original pack away from light, and return unused medicine to a pharmacy.

Common questions

How long will it take to work?
It depends on the infection. Creams, gels and sprays usually start working within a few days. Tablets can take several weeks, and nail infections take the longest, often many months, because the nail has to grow out. See a doctor if a skin infection is not improving or gets worse.

Can I drink alcohol while taking terbinafine?
Yes. NHS advice says you can drink alcohol with terbinafine. With the tablets, cut down on caffeine drinks, as terbinafine can make their effects stronger.

Do I need blood tests with terbinafine tablets?
Possibly. Liver problems are rare, but your doctor may check your liver with a blood test, especially if you take the tablets for a long time.

What if terbinafine does not work?
A doctor may continue the treatment for longer or choose a different antifungal. In South Asia, some ringworm is caused by a fungus that often resists terbinafine, so tell your doctor if the rash keeps spreading or coming back.

Will terbinafine affect my contraception?
It is not likely to affect the combined pill or emergency contraception. Some people notice spotting, so tell a doctor if this happens. If you have severe vomiting or diarrhoea, your pill may not protect you, so check the pill leaflet.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.