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Terbinafine liver disease — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentTerbinafine liver diseaseGPhC CRA

A patient with documented chronic active liver disease presents a new private prescription for oral terbinafine for uncomplicated onychomycosis. No baseline liver tests or specialist plan are available. What should the pharmacist do?

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Correct answer: C — Prescriber review before supply because chronic active liver disease contraindicates treatment

Oral terbinafine is unsuitable in chronic or active liver disease; non-urgent onychomycosis does not justify bypassing that risk. Baseline or ongoing monitoring may detect injury but does not itself remove a contraindication. A partial supply, alcohol advice or unilateral formulation substitution is not an adequate remedy, so the prescription should be queried before any oral supply.

Reference: Lamisil 250 mg tablets SmPC. https://www.medicines.org.uk/emc/product/1031/smpc