Terbinafine is an orally and topically active
allylamine antifungal agent with a primarily fungicidal action in vitro. Its spectrum of in vitro activity includes a broad range of dermatophyte, filamentous, dimorphic and dematiaceous fungi, and some yeast species. In clinical trials, mycological and overall efficacy rates of around 90 and 80%, respectively, have been achieved in cutaneous dermatophyte
infections (
tinea corporis/cruris and
tinea pedis) with
terbinafine, administered either orally (250 or 500 mg/day) or topically (a 1% cream applied twice daily). Similar rates of cure have been obtained with oral
terbinafine in dermatophyte nail
infections after relatively short treatment periods ranging from 3 to 12 months. Topical
terbinafine has been effective in approximately 80% of patients with
cutaneous candidiasis or
pityriasis versicolor. Few comparative data have been published, but generally oral
terbinafine appeared to be at least as effective as oral
griseofulvin or
ketoconazole in
tinea corporis/cruris and more effective than
griseofulvin in
tinea pedis. Both oral and topical
terbinafine have been very well tolerated in clinical trials to date, with only minor adverse effects reported. Although further research is required to establish the efficacy of
terbinafine in comparison with other available
therapies, as well as to fully clarify its tolerability profile, the early results obtained with
terbinafine in superficial
fungal infections are very encouraging.
Terbinafine appears likely to become a first-line
therapy for dermatophyte
infections, particularly those affecting the nails.