The Experts below are selected from a list of 10227 Experts worldwide ranked by ideXlab platform
H W Jolly - One of the best experts on this subject based on the ideXlab platform.
-
Treatment of tinea cruris with topical Terbinafine.
Journal of the American Academy of Dermatology, 1990Co-Authors: D L Greer, H W JollyAbstract:Twenty-three patients were enrolled in a randomized, double-blind trial of Terbinafine 1% cream versus its vehicle (placebo) in the treatment of tinea cruris. One patient had a negative initial culture and was excluded, and two patients were dropouts, one because of poor study compliance (Terbinafine) and one because of an adverse event (placebo). Twenty patients were examined for efficacy of treatment (9 Terbinafine-treated, 11 placebo-treated). Both groups were similar in age, sex, duration of disease, prior therapy, size and location of lesion, infecting organism, and predisposing factors. Terbinafine 1% cream was more effective than vehicle cream in the reduction of the signs and symptoms of tinea cruris. In addition, there was a higher conversion rate to negative culture and normal microscopy findings in the Terbinafine-treated group. Clinical results combined with evaluation of mycologic tests at end of therapy showed Terbinafine to be a rapid and significantly more effective treatment for tinea cruris than placebo (78% vs 18% cure rate, respectively). Follow-up cure rates confirmed these findings (89% and 18%, respectively). No significant adverse events occurred during Terbinafine treatment.
-
Treatment of tinea cruris with topical Terbinafine
Journal of the American Academy of Dermatology, 1990Co-Authors: D L Greer, H W JollyAbstract:Abstract Twenty-three patients were enrolled in a randomized, double-blind trial of Terbinafine 1% cream versus its vehicle (placebo) in the treatment of tinea cruris. One patient had a negative initial culture and was excluded, and two patients were dropouts, one because of poor study compliance (Terbinafine) and one because of an adverse event (placebo). Twenty patients were examined for efficacy of treatment (9 Terbinafine-treated, 11 placebo-treated). Both groups were similar in age, sex, duration of disease, prior therapy, size and location of lesion, infecting organism, and predisposing factors. Terbinafine 1% cream was more effective than vehicle cream in the reduction of the signs and symptoms of tinea cruris. In addition, there was a higher conversion rate to negative culture and normal microscopy findings in the Terbinafine-treated group. Clinical results combined with evaluation of mycologie tests at end of therapy showed Terbinafine to be a rapid and significantly more effective treatment for tinea cruris than placebo (78% vs 18% cure rate, respectively). Follow-up cure rates confirmed these findings (89% and 18%, respectively). No significant adverse events occurred during Terbinafine treatment.
Howard I. Maibach - One of the best experts on this subject based on the ideXlab platform.
-
Terbinafine induced lichenoid drug eruption
Cutaneous and Ocular Toxicology, 2017Co-Authors: Yue Zheng, Haiyan Chen, Jie Zhang, Howard I. MaibachAbstract:Drug-induced lichen planus has been induced by antibiotics, anticonvulsants, antidiabetics, antimalarials, antitubercular drugs, antihypertensives, psychiatric drugs, chemotherapeutic agents, diuretic, heavy metals, NSAIDs, etc. Terbinafine, an antifungal agent, is widely used for dermatophyte infections and onychomycosis. Cutaneous adverse effects of Terbinafine are rarely reported. Here, we report a case of Terbinafine-induced lichenoid drug eruption in a 22-year-old who presented with generalized lichenoid eruption 2 weeks after Terbinafine initiation of. The body and lip cleared completely after 8 weeks of drug withdrawal; nail change cleared after 12 weeks.
-
onychopharmacokinetics of Terbinafine hydrochloride penetration from a novel topical formulation into the human nail in vitro
Drug Development and Industrial Pharmacy, 2013Co-Authors: Xiaoying Hui, Ake Lindahl, Sonia A Lamel, Howard I. MaibachAbstract:This study determined the onychopharmacokinetics, nail absorption, distribution, and penetration of [14C]-Terbinafine HCl in a new topical formulation into/through the human finger nail using the in vitro finite dose model. This study determined the penetration rate of Terbinafine HCl from multiple doses of topical formulation applied daily for 14 days. Results showed that the total dose recovery (mass balance) was almost 100%. The concentration of Terbinafine HCl in the deeper nail plate (ventral/intermediate layers) and the cotton-pad nail bed samples after the 14-day treatment were 613 ± 145 and (±S.D.) and 27 ± 1.2 µg/cm3 (or 1.9 ± 0.6 µg/cm3 daily) on average, respectively. In comparison with nail concentration data from the literature for other topical terbinatine formulations, our results show that higher amounts of Terbinafine HCl reached the deep nail plate and/or the nail bed after a 14-day topical treatment with this topical formulation in vitro.
D L Greer - One of the best experts on this subject based on the ideXlab platform.
-
Treatment of tinea cruris with topical Terbinafine.
Journal of the American Academy of Dermatology, 1990Co-Authors: D L Greer, H W JollyAbstract:Twenty-three patients were enrolled in a randomized, double-blind trial of Terbinafine 1% cream versus its vehicle (placebo) in the treatment of tinea cruris. One patient had a negative initial culture and was excluded, and two patients were dropouts, one because of poor study compliance (Terbinafine) and one because of an adverse event (placebo). Twenty patients were examined for efficacy of treatment (9 Terbinafine-treated, 11 placebo-treated). Both groups were similar in age, sex, duration of disease, prior therapy, size and location of lesion, infecting organism, and predisposing factors. Terbinafine 1% cream was more effective than vehicle cream in the reduction of the signs and symptoms of tinea cruris. In addition, there was a higher conversion rate to negative culture and normal microscopy findings in the Terbinafine-treated group. Clinical results combined with evaluation of mycologic tests at end of therapy showed Terbinafine to be a rapid and significantly more effective treatment for tinea cruris than placebo (78% vs 18% cure rate, respectively). Follow-up cure rates confirmed these findings (89% and 18%, respectively). No significant adverse events occurred during Terbinafine treatment.
-
Treatment of tinea cruris with topical Terbinafine
Journal of the American Academy of Dermatology, 1990Co-Authors: D L Greer, H W JollyAbstract:Abstract Twenty-three patients were enrolled in a randomized, double-blind trial of Terbinafine 1% cream versus its vehicle (placebo) in the treatment of tinea cruris. One patient had a negative initial culture and was excluded, and two patients were dropouts, one because of poor study compliance (Terbinafine) and one because of an adverse event (placebo). Twenty patients were examined for efficacy of treatment (9 Terbinafine-treated, 11 placebo-treated). Both groups were similar in age, sex, duration of disease, prior therapy, size and location of lesion, infecting organism, and predisposing factors. Terbinafine 1% cream was more effective than vehicle cream in the reduction of the signs and symptoms of tinea cruris. In addition, there was a higher conversion rate to negative culture and normal microscopy findings in the Terbinafine-treated group. Clinical results combined with evaluation of mycologie tests at end of therapy showed Terbinafine to be a rapid and significantly more effective treatment for tinea cruris than placebo (78% vs 18% cure rate, respectively). Follow-up cure rates confirmed these findings (89% and 18%, respectively). No significant adverse events occurred during Terbinafine treatment.
Aditya K Gupta - One of the best experts on this subject based on the ideXlab platform.
-
Terbinafine in the treatment of dermatophyte toenail onychomycosis a meta analysis of efficacy for continuous and intermittent regimens
Journal of The European Academy of Dermatology and Venereology, 2013Co-Authors: Aditya K Gupta, Maryse Paquet, Fiona C Simpson, A TavakkolAbstract:Objective To compare mycological and complete cures of Terbinafine continuous and intermittent regimens in the treatment of toenail onychomycosis. Methods The PubMed database was searched using the terms ‘‘Terbinafine’’, ‘‘onychomycosis’’, ‘‘continuous’’ and ‘‘pulse(d)’’ or ‘‘intermittent’’. The inclusion criteria were head-to-head comparison of Terbinafine pulse and continuous regimens for dermatophyte toenail infections. Risk ratios were calculated for intention-to-treat and evaluable patient analyses, when possible. Pooled estimates for total and subgroup analyses were calculated using a random effect model, Mantel-Haenszel method and their probabilities were calculated with z-statistics. Results Nine studies from eight publications were included. Two continuous regimens and four intermittent regimens were investigated. A pooled risk ratio of 0.87 was obtained for intention-to-treat (95% CI: 0.79–0.96, P = 0.004, n = 6) and evaluable patient (95% CI: 0.80–0.96, P = 0.003, n = 8) analyses of mycological cure, favouring continuous Terbinafine. For complete cure, pooled risk ratios of 0.97 (95% CI: 0.77–1.23, P = 0.82, n =7 ) for intention-to-treat and 0.93 (95% CI: 0.76–1.13, P = 0.44, n = 9) for evaluable patient analyses showed equality of the two regimens. The pulse regimen that demonstrated consistently comparable results to the continuous Terbinafine regimen was two pulses of Terbinafine 250 mg ⁄ day for 4 weeks on ⁄ 4 weeks off. Conclusions Meta-analysis of published studies of toenail onychomycosis showed that a continuous Terbinafine regimen is generally significantly superior to a pulsed Terbinafine regimen for mycological cure. In contrast, some pulse Terbinafine regimens were as effective as continuous Terbinafine regimens for complete cure.
-
the use of an intermittent Terbinafine regimen for the treatment of dermatophyte toenail onychomycosis
Journal of The European Academy of Dermatology and Venereology, 2009Co-Authors: Aditya K Gupta, Lindsay E Lynch, Nataly Kogan, Elizabeth A CooperAbstract:Objective To compare the efficacy and safety of intermittent Terbinafine with standard courses of Terbinafine and itraconazole for dermatophyte toenail onychomycosis. Design Data from a Canadian study of continuous Terbinafine (CTERB) and intermittent itraconazole (III) was compared to an intermittent Terbinafine regimen (TOT) using similar protocol to the randomized study. Interventions Terbinafine 250 mg/day for 4 weeks followed by 4 weeks of no Terbinafine and then an additional 4 weeks of Terbinafine 250 mg/day (TOT); Terbinafine 250 mg/day for 12 weeks (CTERB); itraconazole pulse of 200 mg twice daily for 7 days on, 21 days off, three pulses given (III). Results At 72 weeks, mycological cure rates (negative KOH and culture) were 36 of 43 (83.7%), 25 of 32 (78.1%), and 17 of 30 (56.7%), for the TOT, CTERB, and III groups, respectively (P = 0.01 for TOT vs. III). Effective cure rates (simultaneous mycological cure and ≤10% nail plate involvement) were 34 of 43 (79.1%), 21 of 32 (65.6%), and 11 of 30 (36.7%), respectively (P < 0.001 for TOT vs. III; P = 0.02 for CTERB vs. III). No significant differences in effective and mycological cure rates were noted between the two Terbinafine groups. Adverse events reported were similar to those reported in the respective package inserts. Most adverse events were mild to moderate, transient, and did not require interruption of the drug regimens. No serious adverse events were reported. Conclusions A TOT intermittent Terbinafine regimen provided similar efficacy and safety to the gold standard continuous Terbinafine regimen and better effective cure rates than pulse itraconazole therapy. Conflicts of interest None declared
-
the use of Terbinafine in the treatment of onychomycosis in adults and special populations a review of the evidence
Journal of Drugs in Dermatology, 2005Co-Authors: Aditya K Gupta, Jennifer E Ryder, Lindsay E Lynch, Amir TavakkolAbstract:Terbinafine is an allylamine with fungicidal activity, first approved for the treatment of onychomycosis in the United Kingdom in the early 1990s, and in the US in 1996. Terbinafine is the most frequently prescribed oral antifungal agent in the US and Canada for onychomycosis. Its efficacy and safety in dermatophyte toenail onychomycosis in adults has been established in many studies. In fact, 18 randomized controlled trials have shown Terbinafine to be highly effective, with a meta-average for mycological cure of 76% +/- 3% (mean +/- standard error). In large surveillance studies, Terbinafine exhibited excellent safety profiles consistent with results obtained in pivotal studies. Additionally, Terbinafine has been reported to be superior to both itraconazole and fluconazole in comparative studies in the treatment of dermatophyte toenail onychomycosis. Recent studies have reported Terbinafine to be more cost effective than griseofulvin, fluconazole, or itraconazole. Terbinafine has also been used to treat onychomycosis effectively and safely in special patient populations, such as children, the elderly, immunocompromised patients, diabetics, and those with Down syndrome. Terbinafine should therefore be considered for the management of onychomycosis in adults based on its effectiveness, broad spectrum, fungicidal nature, established safety profile, and very low occurrence of drug interactions. Furthermore, the data support the use of Terbinafine to treat dermatophyte onychomycosis in children and the elderly.
-
The efficacy and safety of Terbinafine in children
Dermatologic clinics, 2003Co-Authors: Aditya K Gupta, Elizabeth A Cooper, Charles LyndeAbstract:In summary, Terbinafine is a broad-spectrum allylamine, which has been used to treat superficial fungal infections including onychomycosis, and some systemic mycoses in adults. With a fungicidal activity, low minimum inhibitory concentration value, and high selectivity for fungal squalene epoxidase, Terbinafine has demonstrated good efficacy in superficial fungal infections. Its lipophilic nature provides excellent, widespread absorption into hair, skin, and nails where it can eradicate fungal infection. Terbinafine has been shown to be effective and safe in several studies of the treatment of tinea capitis and onychomycosis in children. When treating Trichophyton tinea capitis the length of therapy may be 2 or 4 weeks. Microsporum tinea capitis may require somewhat higher or longer doses of Terbinafine for adequate efficacy. These regimens still tend to be shorter than treatment with griseofulvin, and Terbinafine may provide a higher compliance and a more cost-effective means of managing tinea capitis. It is possible that even higher cure rates and a shorter duration of therapy may be achieved following further optimization of treatment regimens that use a higher daily dosage of Terbinafine than is currently recommended. The evidence is strongly in favor of using Terbinafine to treat superficial fungal infections in children.
-
Hypersensitivity syndrome reaction to oral Terbinafine
The Australasian journal of dermatology, 1998Co-Authors: Aditya K Gupta, Andrew J PorgesAbstract:Terbinafine is used extensively to treat onychomycosis and other dermatomycoses. The case of a patient who developed a hypersensitivity syndrome reaction to oral Terbinafine is discussed. A 66-year-old male was placed on Terbinafine (250 mg/day) for the treatment of onychomycosis. After 4.5 weeks of therapy, the patient developed a cutaneous eruption, pyrexia, lymph-adenopathy and hepatic dysfunction. No infectious or other cause was found for the symptoms and signs, which resolved within 6 weeks of stopping Terbinafine. The patient had been on prednisone, doxazosin mesylate and aspirin for several months prior to starting Terbinafine. These medications were continued during the episode and subsequently afterwards, with adjustment to the prednisone dosage only. The hypersensitivity syndrome reaction in this case involved multiple systems and was idiosyncratic in nature with no apparent predisposing factors. With the increasing use of oral Terbinafine, it is likely that rare adverse events will occur more frequently. It is, therefore, important for physicians to be aware of the possible development of a hypersensitivity syndrome reaction in a patient on Terbinafine who experiences an adverse event with multisystem involvement. Prompt recognition and determination of the extent of systemic involvement is important for the proper management of the patient.
Andrew Yule Finlay - One of the best experts on this subject based on the ideXlab platform.
-
Effect of Terbinafine on the pharmacokinetics of cyclosporin in humans.
The Journal of investigative dermatology, 1994Co-Authors: C. Colin Long, S. Hill, R. Thomas, Atholl Johnston, Stephen G. Smith, Francis Kendall, Andrew Yule FinlayAbstract:Cyclosporin is largely metabolized by hepatic cytochrome P450 enzymes, and azole drugs that inhibit cytochrome P450 may precipitate cyclosporin toxicity. The allylamine Terbinafine binds to a small subfraction of hepatic cytochrome P450 in type I fashion, and has no effect upon hepatic metabolism of cyclosporin in vitro. The purpose of this study was to determine whether oral Terbinafine alters the pharmacokinetics of oral cyclosporin in vivo. Twenty male volunteers (age 19-44 years), were randomly allocated to two groups. The first group received three single oral doses of cyclosporin 300 mg at intervals of 21 d. The second and third doses of cyclosporin were preceded by a 6-d course of oral Terbinafine 250 mg each morning. A further 250 mg of Terbinafine was taken with the second and third doses of cyclosporin. Blood levels of cyclosporin and Terbinafine were monitored for 36 h after each dose. The second group received a 7-d course of Terbinafine 250 mg each morning. On the seventh day a single dose of cyclosporin 300 mg was taken together with the Terbinafine. Blood levels of both cyclosporin and Terbinafine were monitored for 36 h. Two further single doses of cyclosporin 300 mg were given at intervals of 2 weeks and the cyclosporin levels again monitored. In both groups each cyclosporin dose was preceded by an 8-h fast. The mean peak blood concentration of cyclosporin when taken alone was 958 micrograms/l, and 822 when taken with Terbinafine. The mean area under the curve for cyclosporin was 4207 micrograms/l/h when taken alone and 3665 when taken with Terbinafine. The mean absorption half-life for cyclosporin when taken alone was 0.29 h, and 0.33 when taken with Terbinafine. The mean time of maximum concentration and elimination half-life of cyclosporin were unaltered by Terbinafine. The results suggest that Terbinafine is likely to prove a safe systemic anti-fungal treatment for patients who are taking cyclosporin.
-
An investigation of the pharmacokinetics of topical Terbinafine (Lamisil®) 1% cream
The British journal of dermatology, 1992Co-Authors: S. Hill, R. Thomas, S. G. Smith, Andrew Yule FinlayAbstract:Twenty human volunteers were entered into a study to investigate the pharmacokinetics of Terbinafine 1% cream. Subjects were randomized to receive Terbinafine 1% cream applied to the back on 1 day, or on 3, 5 or 7 consecutive days. Up to five sequential skin surface biopsies were taken at a site on the upper back at various time-points both during treatment, and following cessation of treatment. Terbinafine levels in these biopsies were analysed using HPLC. The study showed that increasing the number of applications from one to seven did not significantly increase the peak concentration (Cmax) in the stratum corneum. It did, however, increase the total amount of Terbinafine found in the stratum corneum, resulting in Terbinafine being detected for longer periods after cessation of therapy. Treatment for 7 days resulted in Terbinafine still being detectable 7 days after cessation of therapy, when the Terbinafine concentration was significantly higher than the known cidal concentrations for the common causative organisms of superficial dermatomycoses. This study indicates a significant potential for short-duration treatment with Terbinafine (Lamisil) 1% cream in superficial dermatomycoses.
