Medofloran (Terbinafine)

Terbinafine is used to treat infections caused by dermatophytes and other fungi affecting the skin and nails.

• Onychomycosis: eradicates fungal growth in toenails and fingernails, improving nail appearance and health.
• Tinea corporis: clears ring‑shaped skin lesions caused by dermatophyte infection.
• Tinea pedis: relieves athlete’s foot symptoms and eliminates the causative fungus.
• Tinea cruris: treats fungal infection of the groin area, reducing itching and redness.

• Terbinafine inhibits the fungal enzyme squalene epoxidase, a key step in ergosterol synthesis. By blocking this pathway, the drug causes accumulation of squalene, which is toxic to fungal cells, and depletes ergosterol, a vital component of the fungal cell membrane, leading to loss of membrane integrity and cell death.

Terbinafine may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Gastrointestinal upset: nausea, abdominal discomfort, or diarrhea.
• Headache: mild to moderate intensity.
• Skin rash or pruritus: localized itching or erythema.
• Taste disturbance: altered taste perception or loss of taste.
• Elevated liver enzymes: mild, transient increases in hepatic transaminases.

Serious or Rare Side Effects

• Hepatotoxicity: signs of liver injury such as jaundice or dark urine.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hematologic abnormalities: neutropenia or agranulocytosis.
• Peripheral neuropathy: tingling or numbness in extremities.
• Anaphylaxis: rare systemic allergic response requiring immediate medical attention.

Before initiating therapy, clinicians should evaluate patient‑specific factors and monitor for potential risks.

• Liver function assessment: obtain baseline hepatic enzymes and repeat if symptoms arise.
• Hypersensitivity screening: avoid use in patients with known terbinafine allergy.
• Renal impairment caution: adjust dosing in severe kidney disease.
• Drug interaction vigilance: review concomitant medications that affect CYP pathways.
• Pregnancy and lactation: safety data are limited; use only if benefit outweighs risk.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Terbinafine can alter the plasma levels of several co‑administered drugs.

Major Interactions (Avoid)

• Strong CYP2D6 inhibitors (e.g., fluoxetine, paroxetine): may increase terbinafine exposure.
• CYP3A4 inducers (e.g., rifampin, carbamazepine): may reduce therapeutic effectiveness.

Moderate Interactions (Monitor Closely)

• Warfarin: monitor INR as terbinafine can enhance anticoagulant effect.
• Oral contraceptives: efficacy may be decreased; advise additional contraceptive measures.
• Alcohol: concurrent use may heighten risk of liver toxicity.
• Cimetidine: may modestly raise terbinafine concentrations.
• Antihistamines metabolized by CYP2C9: observe for altered response.