terbinafine (topical)

General

Pronunciation:
ter-bin-a-feen

Trade Name(s)

• Apo-Terbinafine 
• Lamisil AT
• Novo-Terbinafine 
• PMS-Terbinafine 

Ther. Class.

antifungals

(topical)

Indications

Treatment of a variety of cutaneous fungal infections, including tinea pedis (athlete's foot), tinea cruris (jock itch), and tinea corporis (ringworm).

Action

Affects the synthesis of the fungal cell wall.

Therapeutic Effect(s):

Decrease in symptoms of fungal infection.

Pharmacokinetics

Absorption: Absorption through intact skin is minimal.

Distribution: Distribution after topical administration is primarily local.

Metabolism and Excretion: Highly metabolized; excreted in urine (primarily as metabolites).

Half-life: 21 hr.

TIME/ACTION PROFILE

Contraindication/Precautions

Contraindicated in:

• Hypersensitivity to active ingredients, additives, preservatives, or bases
• Some products contain alcohol and should be avoided in patients with known intolerance.

Use Cautiously in:

• Nail and scalp infections (may require additional systemic therapy)
• OB:   Lactation: Safety not established.

Adverse Reactions/Side Effects

Local: burning, itching, local hypersensitivity reactions, redness, stinging

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

Not known.

Route/Dosage

Topical (Adults and Children ≥12 yr): Apply twice daily for 1 wk for tinea pedis. Apply once daily for 1 wk for tinea cruris or tinea corporis.

Availability (generic available)

Cream: 1%

Gel: 1%

Spray liquid: 1%

Assessment

• Inspect involved areas of skin and mucous membranes before and frequently during therapy. Increased skin irritation may indicate need to discontinue medication.

Potential Diagnoses

• Risk for impaired skin integrity (Indications) 
• Risk for infection (Indications) 

Implementation

• Consult physician or other health care professional for proper cleansing technique before applying medication.
• Topical Apply small amount to cover affected area completely. Avoid the use of occlusive wrappings or dressings unless directed by physician or other health care professional.

Patient/Family Teaching

• Instruct patient to apply medication as directed for full course of therapy, even if feeling better. Emphasize the importance of avoiding the eyes.
• Caution patient that some products may stain fabric, skin, or hair. Check label information. Fabrics stained from cream can usually be cleaned by handwashing with soap and warm water.
• Patients with athlete's foot should be taught to wear well-fitting, ventilated shoes, to wash affected areas thoroughly, and to change shoes and socks at least once a day.
• Advise patient to report increased skin irritation or lack of response to therapy to health care professional.

Evaluation/Desired Outcomes

Decrease in skin irritation and resolution of infection. Early relief of symptoms may be seen in 2–3 days.