Although most side effects are mild and self-limited, such as headache and gastrointestinal symptoms, taste disturbances (dysgeusia) can range from mild to severe, resulting in weight loss, and have rarely been reported permanent.
Most cases of acute hepatic injury from terbinafine resolve within 3 to 6 months of stopping the medication. In some instances, however, the injury is severe and unremitting, leading to acute liver failure and either death or need for liver transplantation.
For some infections, such as fungal nail infections, you may need to take terbinafine tablets for up to 3 months (sometimes longer). It is safe to take long-term if your doctor tells you to.
Terbinafine-induced liver injury has been reported in the literature. 2-5 The majority of the cases are reversible after discontinuation of the drug. There is at least one report of acute liver failure due to this drug.
Terbinafine - Mechanism of action, Side effects, and Indications [29/31]
How do I know if terbinafine is affecting my liver?
Any symptoms of persistent nausea, anorexia, fatigue, vomiting, right upper abdominal pain or jaundice, dark urine, or pale stools must be reported. Patients with these symptoms should discontinue taking the drug, and the patient's liver function should be immediately evaluated.
Terbinafine has an average rating of 6.3 out of 10 from a total of 456 ratings on Drugs.com. 55% of reviewers reported a positive experience, while 33% reported a negative experience.
For 1 of 45,000–54,000 patients, terbinafine induces symptomatic cholestatic injury that may require liver transplantation or cause death (Terbinafine product monograph: Canada, 1995). While rare, these serious adverse drug effects become significant considering the widespread use of oral terbinafine.
Like many drugs, terbinafine is metabolised by the liver and excreted by the kidneys, consequently a reduction in function of either of those two organ systems could result in serious problems if prescribed to the wrong patient.
Does terbinafine keep working after you stop taking it?
Since fungal infections may be very slow to clear up, you may need to take terbinafine for several weeks or months. If you stop taking terbinafine too soon, your symptoms may return. Terbinafine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses.
A 7-year prospective study of 73 onychomycosis patients who were successfully treated (mycological and clinical cure) with continuous terbinafine or intermittent itraconazole showed that recurrence occurred at a mean time of 36 months after successful treatment [8].
Forty-eight percent achieved a clinical cure compared with only 6% of the placebo group (RR 6.00, 95% CI 3.96 to 9.08; 8 studies, 1,006 people). The mycological cure rate was 59% vs 17% with placebo (RR 4.53, 95% CI 2.47 to 8.33) though there was high variability between individual studies for this outcome.
In a large meta-analysis of antifungals tolerability and hepatotoxicity, the risk of liver injury with standard dose of fluconazole not requiring treatment discontinuation was 9.3%, while the risk of drug discontinuation due to elevated liver enzymes was 0.7% [74].
Actually, small traces of Terbinafine will stay in blood for few weeks. However, its initial half-life is 36 hours, after a week period, the level is significantly at a lower level. So you may safely drink alcohol.
Yes. Terbinafine is one of the antifungal drugs that is known to cause severe hair fall in a few cases. However, this side effect is very rare and may affect only 1 in 10,000 people.
How long does it take for terbinafine to work on toenail fungus?
Systemic medications recommended for treating severe widespread skin infection or nails infected with one of fungal organisms: Terbinafine: 250mg tablets daily (or 125mg twice daily) for 6 weeks for fingernails, 3 to 6 months for toenails. Terbinafine is only effective for dermatophyte infections.
Why should I avoid sunlight while taking terbinafine?
Avoid sunlight. Terbinafine tablets can make your skin sensitive to the sun and the light from sunlamps and tanning beds. You can get a severe sunburn. Use sunscreen and wear a hat and clothes that cover your skin if you have to be in sunlight.
You may become depressed when taking this medicine. Tell your doctor right away if you or your child thinks this medicine is causing changes in your mood or behavior.
What happens if you drink coffee while taking terbinafine?
You may need to limit your Caffeine intake while receiving Terbinafine tablets. Too much Caffeine can cause effects like nausea, nervousness, or sleeplessness. Terbinafine skin creams do not interact. Notes for Professionals: Terbinafine has been shown to inhibit the clearance of caffeine.
The authors concluded that oral antifungal agents are associated with a low incidence of acute liver injury and that it may be fatal, especially for the elderly. They also found that a longer treatment duration may increase the risk of antifungal agent-induced liver injury, especially for ketoconazole [35].
What happens if you have toenail fungus for too long?
A severe case of nail fungus can be painful and may cause permanent damage to your nails. And it may lead to other serious infections that spread beyond your feet if you have a suppressed immune system due to medication, diabetes or other conditions.