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[Terbinafine : Relevant drug interactions and their management]
1Apotheke, Abteilung Arzneimittelinformation & Klinische Pharmazie, Universitätsklinikum Leipzig - AöR, Liebigstr. 20, 04103, Leipzig, Deutschland. axel.duerrbeck@medizin.uni-leipzig.de.
Summary
Terbinafine is a common antifungal, but interactions with certain antidepressants and tamoxifen require careful monitoring. While generally safe, clinicians should be aware of potential drug interactions, especially with tamoxifen, to ensure patient safety.
Area of Science:
- Pharmacology
- Dermatology
- Drug Interactions
Background:
- Terbinafine is a widely prescribed systemic antifungal for skin and nail infections.
- Off-label use in children for onychomycosis and tinea capitis is increasing.
- Generally well-tolerated, especially in elderly and multimorbid patients.
Purpose of the Study:
- To review potential drug interactions with terbinafine.
- To highlight clinically relevant interactions and management strategies.
- To inform safe prescribing practices for terbinafine.
Main Methods:
- Literature review of terbinafine drug interactions.
- Analysis of metabolic pathways and genetic influences on drug metabolism.
- Clinical case considerations for concurrent terbinafine use.
Main Results:
- Terbinafine has few interactions, but caution is advised with antidepressants and cardiovascular drugs.
- Concurrent use with tamoxifen is problematic due to reduced tamoxifen efficacy.
- Metabolism-dependent interactions, particularly with CYP2D6 inhibitors, are clinically significant.
Conclusions:
- Clinically relevant interactions with terbinafine are limited but require monitoring.
- Avoid combining terbinafine with tamoxifen due to diminished therapeutic effect.
- Awareness of potential interactions ensures safe and effective terbinafine therapy.
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