Terbinafine

Provider Level

RN/Paramedic

Class

Antifungal (Allylamine)

Mechanism of Action

Inhibits squalene epoxidase leading to ergosterol deficiency and intracellular squalene accumulation, resulting in fungal cell death.

Indications

Fungal infections including tinea pedis, tinea cruris, tinea corporis, and onychomycosis.

Contraindications

Hypersensitivity to terbinafine. Oral form is contraindicated in patients with chronic or active liver disease.

Routes

PO, Dermal

Onset / Duration

Onset: Variable depending on infection site and route. Duration: Prolonged tissue half-life.

Adverse Effects

Oral: Hepatotoxicity, gastrointestinal upset, headache, taste or smell disturbances. Topical: Local irritation, burning, erythema.

Precautions & Interactions

Discontinue use if signs of hepatotoxicity, progressive skin rash, or severe neutropenia develop. Extreme caution in patients with preexisting renal or hepatic impairment.

Special Considerations

Rarely utilized in acute EMS or prehospital settings. Monitor for signs of allergic reaction or severe hepatic dysfunction if patient is on chronic oral therapy.