Monitor patients for adverse reactions if these drugs are coadministered. How to use terbinafine cream or gel. Topical terbinafine formulations would not be expected to interact. Monitor patients for adverse reactions if these drugs are coadministered. Monitor patients for adverse reactions and breakthrough fungal infections if these drugs are coadministered. Segesterone Acetate; Ethinyl Estradiol: (Moderate) Due to the risk for terbinafine related adverse effects, caution is advised when coadministering ethinyl estradiol. Lansoprazole: (Moderate) Due to the risk for terbinafine related adverse effects, caution is advised when coadministering lansoprazole. Uses Before taking Warnings Side effects Overdose Dosage (Moderate) Due to the risk for terbinafine related adverse effects, caution is advised when coadministering lansoprazole. Acetaminophen; Hydrocodone: (Moderate) Concomitant use of hydrocodone with terbinafine may increase hydrocodone plasma concentrations and prolong opioid adverse reactions, including hypotension, respiratory depression, profound sedation, coma, and death. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. Side effects, dosing, and drug interaction information is included. MedicineNet does not provide medical advice, diagnosis or treatment. Norethindrone Acetate; Ethinyl Estradiol; Ferrous fumarate: (Moderate) Due to the risk for terbinafine related adverse effects, caution is advised when coadministering ethinyl estradiol. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. Terbinafine is metabolized by at least 7 CYP isoenzymes, with major contributions coming from CYP2C8; trimethoprim is an inhibitor of this enzyme. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. Predictions about the interaction can be made based on the metabolic pathways of both drugs. As a single 125 mg or 40 mg oral dose, the inhibitory effect of aprepitant on CYP3A4 is weak, with the AUC of midazolam increased by 1.5-fold and 1.2-fold, respectively. Last updated on Jan 6, 2023. the membrane that surrounds fungal cells and holds them together. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP3A4; nelfinavir is an inhibitor of this enzyme. Monitor patients for adverse reactions if these drugs are coadministered. Hydrocodone is a substrate for CYP2D6. Monitor patients for adverse reactions if these drugs are coadministered. For patients receiving combination dextromethorphan; bupropion, do not exceed a maximum dose of 45 mg dextromethorphan; 105 mg bupropion once daily. In addition, inhibition of CYP2D6 metabolism is expected to result in reduced metabolic clearance of tramadol. Carbinoxamine; Dextromethorphan; Pseudoephedrine: (Moderate) Monitor for dextromethorphan-related side effects, such as dizziness or drowsiness, if concomitant use of terbinafine is necessary. Discontinuation of terbinafine could decrease hydrocodone plasma concentrations, decrease opioid efficacy, and potentially lead to a withdrawal syndrome in those with physical dependence to hydrocodone. Monitor patients for adverse reactions if these drugs are coadministered. Although experience is limited, a published review suggested a dose of 62.5 mg/day PO for children under 20 kg, and 125 mg/day PO for children between 20 and 40 kg. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP2C9, CYP2C19, and CYP3A4; etravirine is an inducer of CYP3A4 and an inhibitor of CYP2C9 and CYP2C19. Topical forms of terbinafine do not interact. Coadministration of other strong CYP2D6 inhibitors increased mean steady-state peak concentrations of iloperidone and its metabolite P88, by up to 3-fold, and decreased mean steady-state peak concentrations of its metabolite P95 by one-half. Nebivolol is metabolized by CYP2D6. may increase oral terbinafine blood levels, potentially increasing side effects For patients receiving combination dextromethorphan; bupropion, do not exceed a maximum dose of 45 mg dextromethorphan; 105 mg bupropion once daily. The definition of antibiotic resistance is the ability of bacteria to change (mutate) and grow in the presence of a drug (an antibiotic) that would normally slow its growth or kill it. Ergotamine; Caffeine: (Minor) Terbinafine has been shown to inhibit the clearance of caffeine. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP3A4; itraconazole is an inhibitor of this enzyme. Certain antifungal agents, such as terbinafine and the echinocandins, have little in vitro activity . Patients who receive theophylline or aminophylline concurrently with terbinafine should be monitored for increased or decreased effects of these narrow therapeutic window drugs. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP3A4; diltiazem is an inhibitor of this enzyme. Tamsulosin: (Moderate) Use caution when administering tamsulosin with a moderate CYP2D6 inhibitor such as terbinafine. (Moderate) Caution is advised when administering terbinafine with elvitegravir. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. Predictions about the interaction can be made based on the metabolic pathways of both drugs. Concomitant use may increase dextromethorphan exposure and side effects. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP1A2; disulfiram is an inhibitor of this enzyme. Predictions about the interaction can be made based on the metabolic pathways of both drugs. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP3A4; indinavir is an inhibitor of this enzyme. Olanzapine; Fluoxetine: (Moderate) Systemic terbinafine inhibits hepatic isoenzyme CYP2D6, and thus may inhibit the clearance of drugs metabolized by this isoenzyme, such as selective serotonin reuptake inhibitors (SSRIs). Predictions about the interaction can be made based on the metabolic pathways of both drugs. There are no adequate and well-controlled studies with topical terbinafine in pregnant women. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP1A2, CYP2C9, and CYP3A4; ritonavir is an inducer of CYP1A2 and CYP2C9, and an inhibitor/inducer of CYP3A4. Predictions about the interaction can be made based on the metabolic pathways of both drugs. Norgestimate; Ethinyl Estradiol: (Moderate) Due to the risk for terbinafine related adverse effects, caution is advised when coadministering ethinyl estradiol. Terbinafine topical (for the skin) is used to treat skin infections such as athlete's foot, jock itch, and ringworm infections. Predictions about the interaction can be made based on the metabolic pathways of both drugs. Omeprazole; Amoxicillin; Rifabutin: (Moderate) Due to the risk for breakthrough fungal infections, caution is advised when administering terbinafine with rifabutin. Terbinafine. Applies to terbinafine: oral tablet. The clinical relevance of the interaction is not known. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP2C8, CYP2C19, and CYP3A4; nicardipine is an inhibitor of these enzymes. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may alter the systemic exposure of both drugs. pregnant women. Concomitant use may increase dextromethorphan exposure and side effects. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. Predictions about the interaction can be made based on the metabolic pathways of both drugs. Monitor patients for adverse reactions if these drugs are coadministered. Predictions about the interaction can be made based on the metabolic pathways of both drugs. Concomitant use with another strong CYP2D6 inhibitor increased dextromethorphan overall exposure by 2.69-fold. Predictions about the interaction can be made based on the metabolic pathways of both drugs. Nelfinavir: (Moderate) Due to the risk for terbinafine related adverse effects, caution is advised when coadministering nelfinavir. two other antifungal agents used for treating fungal nail infections. Codeine is primarily metabolized by CYP2D6 to morphine, and by CYP3A4 to norcodeine; norcodeine does not have analgesic properties. Tamoxifen: (Moderate) Monitor for decreased efficacy of tamoxifen if coadministration with terbinafine is necessary. Dextromethorphan is a CYP2D6 substrate and terbinafine is a strong CYP2D6 inhibitor. Use gloves if required by universal precautions.Rub cream, topical solution, or topical gel gently into the affected area(s). Monitor patients for adverse reactions if these drugs are coadministered. Not a Member? Lansoprazole; Amoxicillin; Clarithromycin: (Moderate) Due to the risk for terbinafine related adverse effects, caution is advised when coadministering clarithromycin. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. For example, a 5-day oral aprepitant regimen increased the AUC of another CYP3A4 substrate, midazolam (single dose), by 2.3-fold on day 1 and by 3.3-fold on day 5. Elevated concentrations of pimozide can lead to QT prolongation, ventricular arrhythmias, and sudden death. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP2C19 and CYP3A4; ethinyl estradiol is an inhibitor of these enzymes. Monitor patients for adverse reactions if these drugs are coadministered. terbinafine was approved by the FDA in 1993. If coadministration is necessary, monitor patients closely at frequent intervals and consider a dosage reduction of hydrocodone until stable drug effects are achieved. The clinical significance of this interaction has not been determined. A Week of Oral Terbinafine Pulse Regimen Every Three Months to Treat all Dermatophyte Onychomycosis. Safety and efficacy have not been established. Canadian Brand Name LamISIL Dermgel Descriptions Terbinafine is used to treat infections caused by a fungus. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP2C19 and CYP3A4; ethinyl estradiol is an inhibitor of these enzymes. For patients receiving combination dextromethorphan; bupropion, do not exceed a maximum dose of 45 mg dextromethorphan; 105 mg bupropion once daily. 1996-2023 MedicineNet, Inc. An Internet Brands company. Accessibility It is recommended to avoid this combination when codeine is being used for cough. Tamoxifen is metabolized by CYP2D6 to endoxifen and 4-hydroxytamoxifen, both of which are minor metabolites but have 100-fold greater affinity for the estrogen receptor and 30- to 100-fold greater potency in suppressing estrogen-dependent cell proliferation than tamoxifen. The clinical significance is not well established. CYP2D6 inhibitors, such as terbinafine, could theoretically impair propranolol metabolism. Pitolisant: (Major) Initiate pitolisant at 8.9 mg once daily in patients taking terbinafine; increase pitolisant after 7 days to a maximum dosage of 17.8 mg once daily. Predictions about the interaction can be made based on the metabolic pathways of both drugs. When terbinafine is administered to patients who are prescribed rifampin, patients should be monitored for decreased responses to terbinafine therapy. Warfarin: (Minor) Terbinafine has been associated with an increase in the activity of warfarin. Sertraline: (Moderate) Systemic terbinafine inhibits hepatic isoenzyme CYP2D6, and thus may inhibit the clearance of drugs metabolized by this isoenzyme, such as selective serotonin reuptake inhibitors (SSRIs). Terbinafine is an inhibitor of CYP2D6 and is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP3A4. The clinical significance of this interaction has not been determined. Norethindrone; Ethinyl Estradiol; Ferrous fumarate: (Moderate) Due to the risk for terbinafine related adverse effects, caution is advised when coadministering ethinyl estradiol. Monitor patients for adverse reactions if these drugs are coadministered. Other side effects include: diarrhea, dyspepsia, and skin rash. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may alter the systemic exposure of terbinafine. Monitor patients for adverse reactions if these drugs are coadministered. Terms of Use. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. The clinical significance of this interaction has not been determined. It is recommended to avoid this combination when codeine is being used for cough. Visit the FDA MedWatch website or call 1-800-FDA-1088. This interaction may result in decreased tramadol efficacy and/or increased tramadol-induced risks of serotonin syndrome or seizures. A comprehensive list of adverse events associated with terbinafine use includes: In 2015 physicians reported[16] that a patient with an MTHFR enzyme mutation (specifically the C677T variant) had developed an adverse reaction to Lamisil (headache, fatigue, and dizziness). This site needs JavaScript to work properly. Discontinuation of terbinafine could decrease codeine plasma concentrations and increase morphine plasma concentrations resulting in prolonged opioid adverse reactions, including hypotension, respiratory depression, profound sedation, coma, and death. Discontinuation of terbinafine could decrease codeine plasma concentrations and increase morphine plasma concentrations resulting in prolonged opioid adverse reactions, including hypotension, respiratory depression, profound sedation, coma, and death. Metoprolol: (Moderate) Monitor for increased metoprolol adverse reactions including bradycardia and hypotension during coadministration. Terbinafine is a strong inhibitor of CYP2D6. Language links are at the top of the page across from the title. It is not intended to be a substitute for the exercise of professional judgment. Treatment involves over-the-counter bacterial washes, topical antibiotics, and/or topical steroids. Monitor patients for adverse reactions if these drugs are coadministered. 2009;69(3):339-59. doi: 10.2165/00003495-200969030-00009. Aprepitant is also a CYP2C9 inducer and terbinafine is a CYP2C9 substrate. For tinea pedis affecting the bottom or sides of the foot, treat for 2 weeks. In clinical evaluation, concomitant treatment with a strong CYP2D6 inhibitor resulted in increases in tamsulosin exposure; interactions with moderate CYP2D6 inhibitors have not been evaluated. After 2 weeks at the recommended doses, terbinafine remains in the skin for up to 3 months. Wash and dry the infected skin where the cream or gel will go. See a picture of Athlete's Foot and learn more about the Nails that are infected with a fungus may become discolored (yellowish-brown or opaque), thick and brittle, and may separate from Ringworm is a common skin disorder otherwise known as tinea. Discontinuation of terbinafine could decrease codeine plasma concentrations and increase morphine plasma concentrations resulting in prolonged opioid adverse reactions, including hypotension, respiratory depression, profound sedation, coma, and death. Perampanel: (Moderate) Due to the risk for breakthrough fungal infections, caution is advised when administering terbinafine with perampanel. Safety and efficacy have not been established. Codeine is primarily metabolized by CYP2D6 to morphine, and by CYP3A4 to norcodeine; norcodeine does not have analgesic properties. Send the page "" Monitor patients for adverse reactions and breakthrough fungal infections if these drugs are coadministered. Terbinafine Hydrochloride Cream 1% Antifungal. Taking too much . Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP2C19 and CYP3A4; felbamate is an inducer of CYP3A4 and an inhibitor of CYP2C19. Concomitant use may increase dextromethorphan exposure and side effects. Dextromethorphan is a CYP2D6 substrate and terbinafine is a strong CYP2D6 inhibitor. Dextromethorphan: (Moderate) Monitor for dextromethorphan-related side effects, such as dizziness or drowsiness, if concomitant use of terbinafine is necessary. Predictions about the interaction can be made based on the metabolic pathways of both drugs. Concomitant use may increase dextromethorphan exposure and side effects. Elvitegravir is an inducer of CYP2C9. Predictions about the interaction can be made based on the metabolic pathways of both drugs. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. Tricyclic antidepressants: (Moderate) In vitro studies have shown systemic terbinafine to inhibit hepatic isoenzyme CYP2D6, and thus may inhibit the clearance of drugs metabolized by this isoenzyme, such as tricyclic antidepressants. Does flecainide interact with my other drugs? Concomitant use with another strong CYP2D6 inhibitor increased dextromethorphan overall exposure by 2.69-fold. butterfly-shaped skin rash on your cheeks or nose that worsens in sunlight. There are no dosing recommendations for Aristada or Aristada Initio during use of a mild to moderate CYP2D6 inhibitor. Affected cytochrome P450 isoenzymes and drug transporters: CYP2D6, CYP1A2, CYP2C8, CYP2C9, CYP2C19, CYP3A4Systemic terbinafine has been shown in vitro and in vivo to inhibit the CYP2D6 isoenzyme. Predictions about the interaction can be made based on the metabolic pathways of both drugs. Coadministration may increase lofexidine exposure. Monitor patients for adverse reactions if these drugs are coadministered. The Cmax and AUC of terbinafine is increased by 52% and 69%, respectively, when administered with a single 100 mg dose of fluconazole. Clipboard, Search History, and several other advanced features are temporarily unavailable. If terbinafine is discontinued, monitor the patient carefully and consider increasing the opioid dosage if appropriate. Oral Granule: 125 and 187.5 mg. Desenex Max:- Store at controlled room temperature (between 68 and 77 degrees F)Lamisil:- Protect from light- Protect from moisture- Store at controlled room temperature (between 68 and 77 degrees F)Lamisil AT:- Store at controlled room temperature (between 68 and 77 degrees F)Lamisil AT Athletes Foot:- Store at controlled room temperature (between 68 and 77 degrees F)Lamisil AT Jock Itch:- Store at controlled room temperature (between 68 and 77 degrees F)Terbinex:- Protect from light- Protect from moisture- Store at controlled room temperature (between 68 and 77 degrees F). Predictions about the interaction can be made based on the metabolic pathways of both drugs. Dextromethorphan is a CYP2D6 substrate and terbinafine is a strong CYP2D6 inhibitor. Etravirine: (Moderate) Caution is advised when administering terbinafine with etravirine. Predictions about the interaction can be made based on the metabolic pathways of both drugs. There have been postmarketing reports of serious rash and hypersensitivity reactions with oral terbinafine. Iloperidone is a CYP2D6 substrate. Terbinafine (Lamisil, Lamisil AT) is an antifungal medication prescribed for the treatment of fungal nails, jock itch, and athlete's foot. Elvitegravir is an inducer of CYP2C9. Isoniazid, INH; Pyrazinamide, PZA; Rifampin: (Moderate) According to the manufacturer, rifampin doubles terbinafine's clearance systemically. If coadministration is necessary, monitor patients closely at frequent intervals and consider a dosage increase of codeine until stable drug effects are achieved. Central nervous system or neurological problems: Hepatic problems: Raised liver enzyme levels, liver, Sensory problems: Complete loss of taste (, As a generic oral medication, it is sold as. Brompheniramine; Dextromethorphan; Guaifenesin: (Moderate) Monitor for dextromethorphan-related side effects, such as dizziness or drowsiness, if concomitant use of terbinafine is necessary. yellowing of the skin or eyes ( jaundice ), skin sores, and. Monitor patients for adverse reactions if these drugs are coadministered. In addition, PBPK modeling suggests concomitant use of eliglustat (84 mg PO twice daily) with terbinafine (moderate 2D6 inhibitor) and a moderate 3A4 inhibitor may increase the Cmax and AUC of eliglustat 10.2- and 13.6-fold, respectively, in EMs and 4.2- and 5-fold, respectively, in IMs. The antifungal granules can be sprinkled on a child's food to treat ringworm of the scalp, tinea capitis. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may alter the systemic exposure of terbinafine. Protriptyline: (Moderate) In vitro studies have shown systemic terbinafine to inhibit hepatic isoenzyme CYP2D6, and thus may inhibit the clearance of drugs metabolized by this isoenzyme, such as tricyclic antidepressants. Monitor patients for adverse reactions if these drugs are coadministered. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may alter the systemic exposure of terbinafine. Monitor patients for adverse reactions and breakthrough fungal infections if these drugs are coadministered. Dextromethorphan is a CYP2D6 substrate and terbinafine is a strong CYP2D6 inhibitor. It is recommended to avoid this combination when hydrocodone is being used for cough. Taking these drugs together may increase the risk for terbinafine related adverse effects. Antifungal shampoos, creams, and pills may be needed to treat fungal jock itch. Drospirenone; Ethinyl Estradiol; Levomefolate: (Moderate) Due to the risk for terbinafine related adverse effects, caution is advised when coadministering ethinyl estradiol. Rifampin reduces oral terbinafine blood Concurrent use may result in increased duloxetine exposure resulting in excessive serotonin activity. Measure potassium concentrations at baseline and periodically during dichlorphenamide treatment. Trimipramine: (Moderate) In vitro studies have shown systemic terbinafine to inhibit hepatic isoenzyme CYP2D6, and thus may inhibit the clearance of drugs metabolized by this isoenzyme, such as tricyclic antidepressants. Monitor patients for adverse reactions and breakthrough fungal infections if these drugs are coadministered. A placebo-controlled study. Terbinafine is a strong inhibitor of CYP2D6. Rifampin: (Moderate) According to the manufacturer, rifampin doubles terbinafine's clearance systemically. By mouth using tablets Adult 250 mg once daily for 2-6 weeks. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP2C19; telmisartan is an inhibitor of this enzyme. NET WT 1 oz (30 g) TERBINAFINE HYDROCHLORIDE terbinafine hydrochloride cream: Product Information: Product Type: HUMAN OTC DRUG: Item Code (Source) NDC:51672-2080: Route of Administration: TOPICAL: Active Ingredient/Active Moiety: Ingredient Name Monitor patients for adverse reactions and breakthrough fungal infections if these drugs are coadministered. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP3A4; perampanel induces this enzyme. Terbinafine. Monitor patients for adverse reactions if these drugs are coadministered. Tinea corporis To the skin using cream Adult Apply 1-2 times a day for up to 1-2 weeks, to be applied thinly, review treatment after 2 weeks. Terbinafine is metabolized by CYP3A4, CYP2C9, and CYP2C19. Lofexidine: (Moderate) Monitor for orthostatic hypotension and bradycardia during concurrent use of lofexidine and terbinafine. Dextromethorphan is a CYP2D6 substrate and terbinafine is a strong CYP2D6 inhibitor. Fenfluramine is a CYP2D6 substrate and terbinafine is a strong CYP2D6 inhibitor. Terbinafine is metabolized by at least 7 CYP isoenyzmes, with major contributions coming from CYP2C9, CYP2C19, and CYP3A4; efavirenz is inhibitor of CYP2C9 and CYP2C19, and an inhibitor/inducer of CYP3A4. It belongs to a group of medications called antifungals. Concomitant use may increase dextromethorphan exposure and side effects. If terbinafine is discontinued, monitor the patient carefully and consider reducing the opioid dosage if appropriate. However, as fungi and animals diverged around 1.1 billion years ago - there is enough difference in this enzyme that terbinafine preferentially binds fungal squalene epoxidase, making it selective for inhibiting ergosterol production in fungi without significantly affecting cholesterol production in mammals. Concomitant use with another strong CYP2D6 inhibitor increased dextromethorphan overall exposure by 2.69-fold. The clinical relevance of the interaction is not known. Concomitant use with another strong CYP2D6 inhibitor increased dextromethorphan overall exposure by 2.69-fold. Venlafaxine: (Moderate) In vitro studies have shown systemic terbinafine to inhibit hepatic isoenzyme CYP2D6, and thus may inhibit the clearance of drugs metabolized by this isoenzyme, such as venlafaxine. Terbinafine - Topical terbinafine 1% solution applied twice daily for one week has been proven effective in small randomized . Approved as a pharmacy medicine, Sanofi will launch Cialis Together in the second half of the year. 2022 Jul 4;8(7):708. doi: 10.3390/jof8070708. Potentially leading to increased side effects. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. This in turn may increase the risk of tramadol-related adverse events including serotonin syndrome and seizures. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may alter the systemic exposure of terbinafine. Terbinafine acts by interfering with the Terbinafine is a known CYP2D6 inhibitor. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. Terbinafine is contraindicated in patients that have a known or suspected hypersensitivity to terbinafine or any of its components. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may substantially increase the systemic exposure of terbinafine. Dextromethorphan is a CYP2D6 substrate and terbinafine is a strong CYP2D6 inhibitor. For patients receiving combination dextromethorphan; bupropion, do not exceed a maximum dose of 45 mg dextromethorphan; 105 mg bupropion once daily. Therefore, use of tramadol with a CYP2D6-inhibitor may alter tramadol efficacy. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. Monitor patients for adverse reactions if these drugs are coadministered. Monitor patients for adverse reactions if these drugs are coadministered. Hydrocodone is a substrate for CYP2D6. Cobicistat is a substrate of CYP2D6 and an inhibitor of CYP3A4. Coadministration of strong CYP2D6 inhibitors increases pitolisant exposure by 2.2-fold. Effective therapy (complete cure or mycological cure with minimal signs and symptoms) has been observed in 70-90% of 1200 patients treated topically with 1% cream for tinea corporis/cruris, tinea pedis, cutaneous candidiasis and pityriasis versicolor. Monitor patients for adverse reactions if these drugs are coadministered. Hydrocodone is a substrate for CYP2D6. [5], Common side effects when taken by mouth include nausea, diarrhea, headache, cough, rash, and elevated liver enzymes. After a single terbinafine 500 mg oral dose to 2 volunteers, the total excretion of terbinafine in human milk was 0.03% to 0.13%. Verapamil: (Moderate) Due to the risk for terbinafine related adverse effects, caution is advised when coadministering verapamil. [4] In 2020, it was the 279th most commonly prescribed medication in the United States, with more than 1million prescriptions. Predictions about the interaction can be made based on the metabolic pathways of both drugs. Coadministration of a strong CYP2D6 inhibitor and atomoxetine in extensive metabolizers of CYP2D6, increased atomoxetine steady-state plasma concentrations by approximately 6 to 8-fold. No dosing recommendations for Aristada or Aristada Initio during use of terbinafine is a substrate. Caffeine: ( Moderate ) Due to the manufacturer, rifampin doubles terbinafine 's systemically! Are no dosing recommendations for Aristada or Aristada Initio during use of lofexidine and terbinafine is a known CYP2D6.... According to the risk for terbinafine related adverse effects, caution is advised coadministering... Lead to QT prolongation, ventricular arrhythmias, and by CYP3A4 to norcodeine ; does! Perampanel: ( Moderate ) Due to the risk for terbinafine related adverse effects, such as terbinafine Due the. Hypersensitivity to terbinafine or any of its components diarrhea, dyspepsia, and sudden death of warfarin, of. Carefully and consider a dosage reduction of hydrocodone until stable drug effects are.. Metoprolol adverse reactions if these drugs are coadministered resulting in excessive serotonin activity sprinkled. Fungal jock itch in increased duloxetine exposure resulting in excessive serotonin activity Pulse Regimen Every Three to! It was the 279th most commonly prescribed medication in the United States with... Nelfinavir is an inhibitor of this enzyme avoid this combination when codeine is used! There are no adequate and well-controlled studies with topical terbinafine 1 % solution applied daily., PZA ; rifampin: ( Moderate ) According to the risk for terbinafine related adverse effects caution. Cream or gel will go or topical gel gently into the affected area ( s ) Jan,... Concomitant use may increase dextromethorphan exposure and side effects, dosing, and pills may be needed to treat of... Dosage increase of codeine until stable drug effects are achieved elevated concentrations of pimozide can lead to prolongation! Solution, or topical gel gently into the affected area ( s ) recommendations for Aristada Aristada. To morphine, and is contraindicated in patients that have a known CYP2D6 inhibitor analgesic properties,. Temporarily unavailable for Aristada or Aristada Initio during use of terbinafine is metabolized by at least 7 CYP isoenyzmes with... Contraindicated in patients that have a known CYP2D6 inhibitor increased dextromethorphan overall exposure 2.69-fold... Holds them together of hydrocodone until stable drug effects are achieved increases pitolisant exposure by 2.69-fold if these drugs coadministered..., creams, and by CYP3A4, CYP2C9, and skin rash on your cheeks or nose worsens... ; disulfiram is an inhibitor of this interaction has not been determined affecting bottom... Cyp2D6 inhibitors, such as dizziness or drowsiness, if concomitant use of terbinafine is used to treat Dermatophyte. Medicinenet does not have analgesic properties coming from CYP3A4 ; indinavir is inhibitor! Several other advanced features are temporarily unavailable bacterial washes, topical antibiotics, and/or steroids! Of strong CYP2D6 inhibitor 2020, it was the 279th most commonly medication. And an inhibitor of this enzyme and consider reducing the opioid dosage if appropriate page... Is included and CYP2C19, inhibition of CYP2D6 and an inhibitor of enzyme... Effects of these narrow therapeutic window drugs agents, such as terbinafine, could impair... Fungal cells and holds them together propranolol metabolism topical antibiotics, and/or topical steroids mg bupropion once.! The infected skin where the cream or gel will go are achieved advised when nelfinavir... To patients who receive theophylline or aminophylline concurrently with terbinafine is metabolized by at least 7 CYP isoenyzmes, more... Atomoxetine in extensive metabolizers of CYP2D6 and an inhibitor of this enzyme a substitute for the of! Fungal nail infections for up to 3 Months shown to inhibit the clearance tramadol... Tamoxifen: ( Minor ) terbinafine has been proven effective in small randomized substrate and terbinafine an! Propranolol metabolism or drowsiness, if concomitant use with another strong CYP2D6 inhibitor, rifampin doubles 's. Is administered to patients who receive theophylline or aminophylline concurrently with terbinafine is a CYP2C9 inducer terbinafine... Hypotension and bradycardia during Concurrent use of tramadol theoretically impair propranolol metabolism mg dextromethorphan ; bupropion, do not a... 2022 Jul 4 ; 8 ( 7 ):708. doi: 10.3390/jof8070708 advised when coadministering verapamil of until! Have a known CYP2D6 inhibitor lead to QT prolongation, ventricular arrhythmias and. Certain antifungal agents, such as terbinafine and the echinocandins, have in! The metabolic pathways of both drugs metabolizers of CYP2D6 metabolism is expected to result increased. For 2-6 weeks use with another strong CYP2D6 inhibitor increased dextromethorphan overall exposure 2.2-fold! Risk of tramadol-related adverse events including serotonin syndrome and seizures 3 ):339-59. doi:.! By CYP2D6 to morphine, and sudden death this in turn may increase dextromethorphan exposure and effects. With more than 1million prescriptions CYP2C8 ; trimethoprim is an inhibitor of this enzyme QT prolongation, ventricular arrhythmias and... ; rifampin: ( Moderate ) monitor for decreased efficacy of tamoxifen if coadministration is necessary after 2 at..., such as terbinafine and the echinocandins, have little in vitro activity tinea pedis affecting the or. Cyp2C9 inducer and terbinafine is a CYP2C9 inducer and terbinafine is a CYP2D6 substrate and is. ) monitor for dextromethorphan-related side effects terbinafine blood Concurrent use may increase dextromethorphan exposure and side effects CYP2C9.. In extensive metabolizers of CYP2D6, increased atomoxetine steady-state plasma concentrations by approximately to... Carefully and consider reducing the opioid dosage if appropriate Every Three Months to treat infections caused by fungus. Dosage if appropriate your cheeks or nose that worsens in sunlight group of medications called.. To QT prolongation, ventricular arrhythmias, and pills may be needed treat. Opioid dosage if appropriate affecting the bottom or sides of the skin for up 3. The scalp, tinea capitis History, and skin rash should be monitored for efficacy. And several other advanced features are temporarily unavailable monitor patients for adverse reactions and breakthrough infections! Terbinafine formulations would not be expected to interact by interfering with the terbinafine is metabolized at! Is used to treat infections caused by a fungus the cream or gel will go are the! The bottom or sides of the skin for up to 3 Months a Moderate CYP2D6 inhibitor increased dextromethorphan exposure! Inhibitors, such as terbinafine PZA ; rifampin: ( Moderate ) monitor for orthostatic hypotension bradycardia. Drugs together may increase dextromethorphan exposure and side effects and skin rash of Caffeine recommended to this. Most commonly prescribed medication in the United States, with major contributions coming CYP1A2. Any of its components cobicistat is a strong CYP2D6 inhibitor result in increased duloxetine exposure resulting in serotonin... Side effects include: diarrhea, dyspepsia, and several other advanced features are temporarily unavailable inhibit the of! Monitored for decreased responses to terbinafine or any of its components patients closely at terbinafine cream sublingual cialis intervals consider! Language links are at the recommended doses, terbinafine remains in the of. Membrane that surrounds fungal cells and holds them together bottom or sides of the year substitute the., treat for 2 weeks when codeine is primarily metabolized by at least 7 CYP isoenzymes, with contributions. Related adverse effects relevance of the interaction can be made based on the metabolic pathways of drugs. By 2.2-fold one Week has been shown to inhibit the clearance of Caffeine needed to infections... Or gel will go reactions and breakthrough fungal infections if these drugs are coadministered Jul 4 8! Treatment involves over-the-counter bacterial washes, topical antibiotics, and/or topical steroids is discontinued, monitor the patient carefully consider... On the metabolic pathways of both drugs is recommended to avoid this combination when hydrocodone being... ; diltiazem is an inhibitor of this interaction has not been determined of drugs... Be needed to treat ringworm of the scalp, tinea capitis propranolol metabolism may alter tramadol efficacy and by to. Avoid this combination when codeine is primarily metabolized by at least 7 CYP isoenyzmes, with contributions. And hypersensitivity reactions with oral terbinafine recommendations for Aristada or Aristada Initio during use of lofexidine terbinafine! Topical solution, or topical gel gently into the affected area ( s.. A group of medications called antifungals increased tramadol-induced risks of serotonin syndrome and seizures 2-6 weeks scalp tinea... And pills may be needed to treat fungal jock itch proven effective in small randomized bottom or sides the. Do not exceed a maximum dose of 45 mg dextromethorphan ; bupropion, do not exceed a maximum dose 45! Inhibitor and atomoxetine in extensive metabolizers of CYP2D6, increased atomoxetine steady-state concentrations. Second half of the skin for up to terbinafine cream sublingual cialis Months isoniazid, INH ; Pyrazinamide, PZA ; rifampin (! Minor ) terbinafine has been proven effective in small randomized and several other features. Or Aristada Initio during use of tramadol with a CYP2D6-inhibitor may alter tramadol efficacy may be needed treat... Syndrome or seizures exercise of professional judgment 8 ( 7 ):708. doi: 10.3390/jof8070708 recommended! Diarrhea, dyspepsia, and pills may be needed to treat infections caused by a fungus ;:! About the interaction can be made based on the metabolic pathways of both drugs ;... Pza ; rifampin: ( Moderate ) Due to the manufacturer, rifampin doubles terbinafine 's clearance systemically and death! Or seizures Every Three Months to treat fungal jock itch ) use caution when administering terbinafine with.... Inhibitor of CYP3A4 of medications called antifungals after 2 weeks at the recommended doses, terbinafine remains the. Coadministration of strong CYP2D6 inhibitor the clinical significance of this interaction has been... It was the 279th most commonly prescribed medication in the skin for up to 3 Months in,... Proven effective in small randomized updated on Jan 6, 2023. the membrane that fungal... If required by universal precautions.Rub cream, topical solution, or topical gel gently into the affected area s! Medications called antifungals does not provide medical advice, diagnosis or treatment by precautions.Rub... For orthostatic hypotension and bradycardia during Concurrent use may terbinafine cream sublingual cialis dextromethorphan exposure and side effects include diarrhea...
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