terbinafine hydrochloride at a glance
Medicine class
Allylamine antifungal
Available forms
Prescription tablets and topical preparations, including cream and film-forming solution
Food
Tablets may be swallowed with water, with or without food
What is terbinafine hydrochloride used for?
Licensed uses depend on the formulation:
Tablets: dermatophyte nail infection and ringworm of the feet, groin or body when oral treatment is appropriate because of the infection’s site, severity or extent.
Cream: athlete’s foot and fungal groin infection caused by susceptible dermatophytes.
Film-forming solution: athlete’s foot in adults.
Oral terbinafine is ineffective against pityriasis versicolor.
How does terbinafine hydrochloride work?
Terbinafine blocks fungal squalene epoxidase, disrupting production of ergosterol needed for the fungal cell membrane. This damages and usually kills susceptible dermatophytes.
terbinafine hydrochloride preparations and strengths
Cream
Route: Cutaneous
Strengths: 1%, 1% w/w
Tablet
Route: Oral
Strengths: 250 mg
How to take terbinafine hydrochloride
Follow the product leaflet or prescriber’s directions. Different formulations are not interchangeable.
Swallow tablets with water, with or without food.
Before applying cream, wash and dry the affected skin. Apply a thin layer to the affected and immediately surrounding area, rub in gently, then wash your hands.
For the film-forming solution, wash and dry both feet and hands, cover the specified areas of both feet, allow the film to dry and do not massage it in.
Topical products are for external use. Rinse thoroughly with running water if they enter the eyes.
terbinafine hydrochloride side effects
Common or expected effects
- Tablets: reduced appetite, nausea, abdominal discomfort, diarrhoea, headache, rash, and muscle or joint pain.
- Tablets can alter or reduce taste; reduced food intake and weight loss may follow.
- Topical products: dryness, peeling, itching, redness, irritation, pain or burning where applied.
Get urgent medical advice
- Signs of liver injury, including jaundice, dark urine, pale stools, persistent nausea, reduced appetite or right-sided upper abdominal pain.
- Severe, spreading, blistering or peeling skin reactions.
- Swelling, breathing difficulty, widespread hives or other signs of serious allergy.
- Unusual bruising or bleeding, fever, sore throat or pronounced weakness suggesting a blood disorder.
- New or worsening lupus or psoriasis symptoms during tablet treatment.
terbinafine hydrochloride in pregnancy
Tablets are generally avoided during pregnancy unless oral treatment is clinically necessary and the expected benefit outweighs potential risk. NHS information reports no evidence that topical terbinafine harms the baby, but the selected topical product information advises use only when clearly necessary. Discuss pregnancy or plans for pregnancy with a prescriber or pharmacist.
terbinafine hydrochloride while breastfeeding
The selected product information advises against oral tablets and these topical products during breastfeeding because terbinafine enters breast milk. NHS advice is less restrictive, particularly for topical treatment, so obtain product-specific advice. Never apply topical terbinafine to the breast and prevent the baby contacting treated skin.
terbinafine hydrochloride interactions
Clinically important interactions mainly concern oral terbinafine. No interactions are known for the selected topical products.
CYP2D6 substrates, including some antidepressants, beta blockers and antiarrhythmics
Terbinafine inhibits CYP2D6 and may increase exposure or alter response, particularly with narrow-therapeutic-index medicines.
Rifampicin
May substantially increase terbinafine clearance and reduce its exposure.
Cimetidine
May reduce terbinafine clearance and increase exposure.
Common questions about terbinafine hydrochloride
Answers are fully visible for fast scanning and source review.
Can tablets be taken with food?
Yes. Swallow them with water; food is not required.
Why might liver blood tests be needed?
Oral terbinafine can rarely injure the liver, including in people without known liver disease. Testing helps identify changes requiring review or discontinuation.
Why can a nail still look infected after treatment has worked?
Damaged nail must grow out before its appearance returns towards normal, so visible improvement can lag behind clearance of the fungus.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.