テルビナフィン

使用用途

• Dermatophytic infections (Pulse therapy)
• Dermatophytic infections
• Dermatophytic infections (when other drugs are not tolerated)
• Dermatophyte (M. canis) mycetomas
• Cryptococcal infections (azole-resistant)
• Antifungal (Systemic/Dermatophytosis)
• Localized Malassezia infections
• Avian mycotic infections (Aspergillus)
• Avian mycotic infections (Aspergillus)
• Avian mycotic infections
• Avian mycotic infections
• Aspergillosis (suspected via leukocytosis and pulmonary nodules)
• Dermatophytic infections

投与方法

考えられる副作用

• Vomiting
• Inappetence
• Diarrhea
• Lethargy (reported in cats)
• Hepatotoxicity / Liver failure (very rare, reported in humans)
• Neutropenia (very rare, reported in humans)
• Serious skin reactions like Toxic Epidermal Necrolysis or Stevens-Johnson syndrome (very rare, reported in humans)
• Diarrhoea
• Increased liver enzymes
• Pruritus (cats)
• Topical irritation (due to alcohol content in topical solutions)
• Transient deafness or impaired hearing (in elderly dogs after administration of ear gel)

注意事項と禁忌

• Known hypersensitivity to terbinafine
• Active or chronic liver disease
• Significantly impaired renal function
• Perforated eardrum (for ear gel administration)
• Generalized demodicosis (topical or systemic use)
• Pregnant animals
• Breeding animals
• > **Hepatic and Renal Warning:** Use with extreme caution, if at all, in patients with markedly impaired liver or renal function. Dosage adjustments should be considered if use is unavoidable. * **Pregnancy/Nursing:** Definitive safety in pregnancy has not been established (FDA Category B in humans). The manufacturer recommends against use in pregnant or nursing individuals, as the drug concentrates in maternal milk at levels 7 times higher than plasma. Use with caution in nursing veterinary patients.

薬物相互作用

• Cyclosporine: Terbinafine may increase the elimination and decrease the efficacy of cyclosporine.
• Rifampin: May increase terbinafine clearance, potentially requiring higher terbinafine doses.
• Beta-blockers: Terbinafine shares the CYP2D6 metabolic pathway and could theoretically alter the metabolism of beta-blockers.
• MAO Inhibitors (e.g., amitraz, selegiline): Terbinafine shares the CYP2D6 metabolic pathway and could theoretically alter the metabolism of MAOIs.
• SSRIs (e.g., fluoxetine): Terbinafine shares the CYP2D6 metabolic pathway and could theoretically alter the metabolism of SSRIs.
• Tricyclic Antidepressants: Terbinafine shares the CYP2D6 metabolic pathway and could theoretically alter the metabolism of TCAs.
• Cimetidine: May decrease the clearance of terbinafine, potentially increasing plasma concentrations (Clinical Pearl)

よくある質問