Terbinafine gives derived primobolan depot bayer ergosterol synthesis in fungi by inhibiting squalene epoxidase enzyme located on the cell membrane of the fungus. This leads to a deficiency of ergosterol and to an intracellular accumulation of squalene, which causes death of fungal cells.
Food does not affect the bioavailability.After a single dose of terbinafine into the maximum drug concentration achieved after 2 hours of blood plasma. The drug was well absorbed when administered orally , rapidly penetrates into the dermal layer of the skin and accumulate in the stratum corneum and nail plates provide fungicidal action. Quickly penetrates into sebum, leading to the creation of a high concentration in the hair follicles, the hair, the skin, subcutaneous tissue.Biotransformiroetsa in the liver to inactive metabolites; about 70% of the dose is excreted in the urine.The half-life is 17 hours. The half-life in the terminal phase -. 200-400 hours not cumulated in the body. There primobolan depot bayer were no changes in the equilibrium concentration of terbinafine in dependence of age, in patients with renal insufficiency or in patients with hepatic cirrhosis rate of excretion of the drug may be slowed, resulting in higher concentrations of terbinafine in plasma.
– fungal infections of the scalp (trihofitia, mikrosporiya)
– fungal diseases of smooth skin – treatment of common tinea trunk and extremities;
– candidiasis skin and mucous membranes, caused by fungi of the genus of Candida – in cases where the localization or distribution process determine the feasibility of oral therapy.
: Hypersensitivity to terbinafine or any other components of the drug.
Precautions – alcoholism, blood diseases, cancer primobolan depot bayer, metabolic diseases, pathology limbs. Children’s age – up to 2 years.
Dosing and Administration
Duration of treatment and dosage regimen is established individually and depends on the process of localization and severity of the disease.
Adults are usually administered orally after a meal to 250 mg once a day.
Patients with hepatic and renal insufficiency – 125 mg 1 time per day.
Fungal infections of the skin
The recommended duration of treatment:
Tinea pedis (interdigital, plantar or type “socks”): 2-6 weeks
Tinea trunk, extremities – 2-4nedeli,
skin and mucosal candidiasis – 2-4 weeks.
Complete disappearance of the clinical manifestations of the disease there are usually a few weeks after mycological cure.
Fungal infections of the scalp
The recommended duration of treatment:
. Mycosis of the scalp – about 4 weeks
Mycosis of the scalp occurs mainly in children.
The duration of drug treatment for most patients is 6-12 weeks. In onychomycosis brushes in most cases it is 6 weeks, and at onychomycosis a stop – 12 weeks. Some patients who have a decreased rate of nail growth, may require longer treatment. The optimal clinical effect is seen some months after mycological cure and cessation of therapy. This is determined by the period of time that is required for regrowth of healthy nail.
Use of the drug in children
Children drug designate to two years. The dose depends on the body weight of the child and of:
for children weighing 20 kg dog – 62.5 mg / day
from 20 kg to 40 kg – 125 mg / day;
more than 40 kg – 250 mg / day.
Data on drug use among children primobolan depot bayer aged up to two years (with a body weight less than 12 kg) are not available.
Lamikan generally well tolerated. Side effects usually are mild or moderate and transient in nature are.
If ingestion may occur:
– the part of the gastrointestinal tract and liver: dyspepsia, abdominal pain, feeling of fullness, nausea, loss of appetite, diarrhea; sometimes taste disturbance, including their loss (restored several weeks after cessation of treatment).
– From the musculoskeletal system: muscle pain, joint pain.
– From the hematopoietic system: neutropenia, agranulocytosis, thrombocytopenia, rarely – lymphopenia.
– Allergic reactions: skin rash in the form of spots, blisters, seldom – toxic epidermal necrolysis, Stevens-Johnson syndrome, anaphylactoid reactions.
orally in recommended doses is not described Until now, cases of overdose when taking terbinafine. In acute overdose of the drug may develop nausea, vomiting, pain in the epigastric region.
Treatment: gastric lavage, followed by the appointment of activated carbon; if necessary – symptomatic supportive therapy.
Interaction with other medicinal products
Terbinafine in vitro has a very low ability to alter the clearance of most drugs that are metabolized with participation of cytochrome P450 (eg tsoklosporina, terfenadine, tolbutamide, triazolam or oral contraceptives).
In women, while taking terbinafine and oral contraceptives, may experience irregular menstruation. The total clearance of terbinafine may be accelerated by drugs that cause induction of cytochrome P450 enzymes (such as rifampicin) and may slow down drugs – inhibitors of the cytochrome P450 system (eg, cimetidine), if necessary, the simultaneous use of these drugs may require dose adjustment.
Caffeine clearance reduces by 20%.
Terbinafine does not affect the clearance of antipyrine, digoxin, warfarin.
Ethanol and other hepatotoxic drugs increases the risk of hepatotoxicity.
Irregular use or premature ending primobolan depot bayer of treatment increases the risk of relapse.
If after 2 weeks of treatment, no improvement in the state, it is necessary to re-determine the causative agent and its sensitivity to the drug.
Care should be taken when appointing Lamikana into patients with impaired hepatic function and (or) of the kidneys. If any symptoms suggestive of liver dysfunction (lack of appetite, fatigue, persistent nausea, jaundice, dark urine), you need to remove the drug. Patients with chronic disorders of the liver and kidney primobolan depot bayer function should be given half the usual recommended dose of the drug and monitor indicators of liver and kidney function during treatment.