In renal failure, alcoholism, inhibition of bone marrow hematopoiesis, tumors, metabolic diseases, vascular occlusive diseases of the limbs.
It is not recommended to appoint in patients with chronic or active liver disease. Prior to his appointment tablets is necessary to determine whether the patient’s previous liver disease.Hepatotoxicity may occur in patients with liver diseases previous or without them. Patients who are prescribed anavar side effects , should be warned that you should immediately inform your doctor about the origin of the intake of these symptoms the drug as persistent nausea, anorexia, fatigue, vomiting, pain in the right upper quadrant, jaundice, dark urine or light cal. In the event of such symptoms should immediately stop taking the drug and to conduct a study of liver function.
Application of pregnancy and lactation
Experimental studies do not suggest the presence anavar side effects of adverse events in relation to fertility and of toxic effects on the fetus. Since clinical experience in pregnant women is very limited, you should not use the drug during pregnancy except in cases where the expected benefits of therapy outweighs the potential risk.
Terbinafine is excreted in breast milk, therefore women receiving inside, not You should breastfeed.
Dosing and Administration
Duration of treatment and dosage regimen is established individually and depends on the process of localization and severity of the disease. Adults and children weighing more than 40 kg is usually administered orally after meal 1 tablet (250 mg) once a day. Skin infections Recommended duration of treatment: Tinea pedis (interdigital, plantar or by type of socks): 2-6 weeks. Tinea trunk drumsticks: 2-4 weeks. skin Candidiasis:. 2-4 weeks The complete disappearance of the manifestations of infection and complaints associated with it, may occur no earlier than a few weeks after mycological cure. hair infections and scalp Recommended anavar side effects duration of treatment: mycosis of the scalp:. 4 weeks Fungal infections of the scalp mostly seen in children. Onychomycosis The duration of treatment for most patients from 6 to 12 weeks. In onychomycosis brushes in most cases enough to 6 weeks of treatment. In onychomycosis stop in most cases enough to 12 weeks of treatment. Some patients who have a decreased rate of nail growth, may require longer treatment. The optimal clinical effect is seen some months after mycological cure and cessation of therapy. This is determined by the period of time that is required for regrowth of healthy nail. Use in the elderly There is no evidence to suggest that elderly people need to change the drug dosage regimen, or that they have marked side effects that differ from those in younger patients. In the case of use in this age group of the drug in tablets should consider the possibility of concomitant abnormal liver or renal function.
Antifungal agent for topical application, with a wide range of antifungal activity. At low concentrations terbinafine has fungicidal activity against dermatophytes, (Trichophyton rubrum, T.mentagrophytes, T.verrucosum , T.violaceum, Microsporum canis, Epidermophyton floccosum), mold (mainly C. albicans) and certain dimorphic fungi (Pityrosporum orbiculare) . Activity against yeast fungi, depending on their type, may be a fungicidal or fungistatic.
Terbinafine changes occurring ergosterol biosynthesis in fungi by inhibiting squalene epoxidase enzyme located on the cell membrane of the fungus. This leads to a deficiency of ergosterol and to an intracellular accumulation of squalene, which causes death of fungal cells.
Terbinafine has no effect on the cytochrome anavar for women system in humans and, therefore, the metabolism of hormones or other drugs.
Pharmacokinetics. When applied topically absorption – less than 5% has little systemic effect.
: Hypersensitivity to terbinafine or to any of the inactive components of the composition of the drug.
Precautions: hepatic and / or renal failure, alcoholism, depression of bone marrow hematopoiesis, tumors, metabolic diseases, limb occlusive vascular disease, children under 12 years anavar for women of age (lack of sufficient clinical experience).
Pregnancy and lactation. In experimental research teratogenic properties of terbinafine have been identified. So far no reports of any malformation when applying Terbinoksa. However, as clinical experience with Terbinoksa in pregnant women is very limited, it should be used only on strict conditions.
Terbinafine is excreted in breast milk, however when using the drug nursing mother any negative impact on the child is unlikely because systemic absorption through the skin cream is very small.
Dosage and administration:
Adults and children from 12 years:
should be clean and dry the affected area before applying the cream. The cream is applied thinly to the affected skin and surrounding areas 1 or 2 times a day and gently rubbed. For infections involving intertrigo (under the breasts, in the interdigital spaces, between the buttocks, groin), cream application site can cover the gauze, especially at night.
The average duration of treatment: Tinea torso, legs: 1 week 1 time per day. Tinea pedis: . 1 week 1 time per day Skin Candidiasis: 1-2 weeks 1 or 2 times a day. Colorful versicolor: 2 weeks 1 or 2 times day.
The reduction or disappearance of the main anavar for women clinical manifestations of the disease is usually observed in the first days of therapy. In the case of irregular treatment or premature discontinuation of treatment there is a risk of renewed infection. If after 1-2 weeks of treatment, improvement of disease symptoms were observed, there should be verified diagnosis.
The dosage regimen of the drug in the elderly is not different from the above.
Use of the drug in children
is not recommended to use the drug in children under 12 years old.
In rare cases, the site of application of the drug may appear redness, itching or burning. Allergic reactions.
So far, cases of overdose have been reported. If accidentally Terbinoks cream is ingested, it is possible to expect development of the same side effects as an overdose of pills Terbinoks (headache, nausea, epigastric pain and dizziness).
Treatment: activated charcoal, if necessary – symptomatic supportive therapy.
are any drug interactions are not known for Terbinoksa cream.
Reducing the severity of clinical manifestations are usually noted in the first days of treatment. Irregular use or premature ending of treatment increases the risk of recurrent infection.
The drug is intended for external use only, so you should avoid getting the cream on the mucous membrane of eyes, because it can cause irritation.
In case of accidental contact with the drug immediately wash out the eye with running water, and in the case of persistent phenomena of irritation consult a doctor. With the development anavar for women of allergic reactions need to stop the drug.
If the drug has come into disrepair or expiration date – do not throw it in the waste water
Symptoms: nausea, vomiting, pain in the lower abdomen in the epigastric region. Treatment: gastric lavage, followed by the appointment of activated carbon and / or symptomatic therapy.
Interaction with other drugs
inhibits isoenzyme liquid anavar and inhibits the metabolism of drugs such as tricyclic antidepressants and selective serotonin uptake blockers (napr. desipramine, fluvoxamine) of b1-blockers (metoprolol, propranolol), antiarrhythmics (flecainide, propafenone), (eg., selegiline) antipsychotic and (eg., chlorpromazine, haloperidol).
Medications Inductors enzymes (eg. Rifampicin) can accelerate the excretion of terbinafine from the body. Medications inhibitors (eg. Cimetidine) may slow the metabolism and excretion of terbinafine from the body. With the simultaneous use of these drugs may require dose adjustment of terbinafine.
Possible disruption of the menstrual cycle, while the reception of terbinafine and oral contraceptives. It reduces the clearance of caffeine by 21% and prolongs its half-life by 31%. It does not affect the clearance of phenazone, digoxin, warfarin. Ethanol and other hepatotoxic drugs increase the risk of hepatotoxic effects.
Irregular use of terbinafine or premature discontinuation of treatment may lead to recurrence of the disease. On the duration of therapy can influence factors such as the presence of comorbidities, the state of the nails in the beginning of treatment. If after 2 weeks of treatment of skin infection is not marked improvement, it is necessary to re-determine the causative agent and its sensitivity to the drug.
Systemic application in onychomycosis is justified liquid anavar only in case of total destruction of the majority of the nails, the presence of pronounced subungual hyperkeratosis, ineffectiveness of previous local therapy.In the treatment of onychomycosis clinical response is usually seen after a few months after mycological cure and treatment discontinuation rate due to the rate of regrowth of healthy nail. Removal of the nail plate in the treatment of onychomycosis of brushes for 3 weeks. and onychomycosis stop for 6 weeks. not required.
If you have severe renal insufficiency (creatinine clearance less than 50 ml / min or creatinine in the blood of more than 300 mmol / l), with abnormal liver function the dose of terbinafine should be halved. If you have liver disease clearance of terbinafine can be reduced. With reduced liver function is assigned half of the adult dose. During treatment is necessary to control the level of liver transaminases in the serum.
In rare cases, after 3 months of treatment there is cholestasis and hepatitis. When liver function disorders symptoms (fatigue, persistent nausea, loss of appetite, abdominal pain, jaundice, dark urine or stool, colorless) the drug should be discontinued.
Appointment of terbinafine patients with psoriasis requires more diligence, because In very rare cases, terbinafine may trigger psoriasis flare. In the treatment of terbinafine should comply with the general rules of hygiene to prevent the possibility of re-infection through underwear and shoes. During the treatment liquid anavar. And at the end of treatment needed to produce the antifungal treatment of shoes, socks and stockings.
From the blood and lymphatic system: very rarely – neutropenia, thrombocytopenia, agranulocytosis, lymphopenia, isolated cases of pancytopenia.
For the skin: very rarely – psoriasis-like rash, exacerbation of psoriasis, acute generalized pustular rash.
Allergic reactions: very often – rash, hives; very rarely – angioneurotic edema, malignant epidermal erythema (Stevens-Johnson syndrome), anaphylactoid reactions, toxic epidermal necrolysis (Lyell’s syndrome).
From the musculoskeletal system: very often anavar only cycle – arthralgia, myalgia.
On the part of the central and peripheral nervous system: often – headache; rarely – paresthesia, gipostezii, dizziness; rarely -depressiya, anxiety.
On the part of the organ of hearing and labyrinth disorders: very rare – vertigo.
Other: rarely – malaise, weakness; very rare – systemic lupus erythematosus, including cutaneous form.
Overdosing Symptoms: nausea, vomiting, headache, dizziness, gastralgia, frequent urination, rash. Treatment: gastric lavage followed by activated carbon. If necessary spend symptomatic therapy.
Interaction with other drugs
is required terbinafine dose adjustment while the use of inhibitors and inducers of cytochrome anavar only cycle isoenzymes, which can slow down and speed up the excretion of terbinafine from the body. Cimetidine reduces terbinafine clearance rate of 30% and increases the rate of excretion of rifampicin 100% terbinafine. Studies in vitro and in vivo showed that terbinafine inhibits isozyme , gives metabolism tricyclic antidepressants, selective serotonin reuptake inhibitors (desipramine, fluvoxamine), beta-blockers (metoprolol, propranolol), antiarrhythmics (flecainide, propafenone), monoamine oxidase inhibitors B (selegiline) and antipsychotic agents (chlorpromazine, haloperidol).
Terbinafine does not influence the rate of excretion tolbutamina, terfinadina, triazolam, oral contraceptives, which are metabolised via other cytochrome.
Terbinafine does not influence the rate of excretion of antipyrine and digoxin. At the same time taking terbinafine and oral contraceptives may develop irregular menstruation. Terbinafine may enhance the effectiveness of caffeine, due to the increase of its concentration in plasma and reduce the clearance rate from the body by 21%.
Terbinafine may decrease the rate of excretion of desipramine by 82%.
Terbinafine may reduce the effectiveness of cyclosporine, by reducing plasma concentration of 15%.
In an application with warfarin may affect the prothrombin test indicators: blood clotting time and international normalized ratio.
When combined with ethanol or drugs having gepatoksicheskim action, there is the risk of liver disease drug.
Irregular use of terbinafine or premature discontinuation of treatment may lead to recurrence of the disease. If after 2 weeks of treatment of skin infection is not marked improvement, it is necessary to re-determine the causative agent and its sensitivity to the drug.
Systemic application in onychomycosis is justified only in case of defeat, most nails, availability pronounced subungual hyperkeratosis, ineffectiveness of previous local therapy. In the treatment of onychomycosis clinical response, laboratory confirmed, usually occurs several months after mycological cure and treatment discontinuation rate due to the rate of regrowth of healthy nail. Removal of the nail plate in the treatment of onychomycosis of brushes for 3 weeks and onychomycosis stop for 6 weeks is required.
In the presence of liver disease may be the clearance of terbinafine is reduced. During treatment necessary to control indicators of activity of “liver” transaminases in blood serum.
In rare cases, after 3 months of treatment there is cholestasis and anavar only cycle hepatitis. When liver function disorders symptoms (fatigue, persistent nausea, loss of appetite, excessive abdominal pain, jaundice, dark urine or discolored feces) drug should be discontinued.
Appointment of terbinafine psoriasis patients requires caution, because very rarely terbinafine can cause exacerbation of psoriasis.
In the treatment of terbinafine should comply with the general rules of hygiene to prevent the possibility of re-infection through underwear and shoes. During the treatment (2 weeks) and at the end it is necessary to produce the antifungal treatment of footwear, socks and stockings.
Effects on ability to drive the vehicle and management mechanisms
Terbinafine does not influence the ability to drive and anavar only cycle operate machinery. However, it should be appreciated that the dizziness can occur during treatment.