Instructions for use of the drug Lamisil

Terbinafine hydrochloride is used as an active component in the production of the drug Lamisil. It is this chemical that is considered one of the most effective remedies against fungal disorders in humans. Before taking the medicine, the instructions for Lamisil gel or tablets should be carefully studied by the patient. Also, do not forget about consulting a specialist.

Only an experienced doctor will be able to correctly assess the effectiveness of the drug in a particular case. Here it is necessary to take into account the characteristics of the patient’s body and check it for possible allergic reactions. If you ignore these studies, the remedy may turn out to be not only useless, but also destructive.

Release form and composition

Dosage forms:

• Tablets: from white with a yellowish tint to white, round biconvex shape, with a chamfer, smooth or rough surface, on the side with a dividing line there is an inscription around the tablet “LAMISIL 250” (in blisters: 7 pcs., in a cardboard pack 1 blister; 14 pcs., 1 or 2 blisters in a cardboard box);
• Cream for external use: homogeneous white structure with a characteristic faint odor (15 or 30 g in aluminum tubes, 1 tube in a cardboard pack);
• Spray for external use: colorless or light yellow transparent liquid with a specific odor (15 ml or 30 ml in high-density polyethylene bottles with a spray tip, 1 bottle in a cardboard box).

Active ingredient: terbinafine hydrochloride:

• 1 tablet – 250 mg;
• 1 g of cream – 10 mg;
• 1 g of spray – 10 mg.

Auxiliary components:

• Tablets: colloidal anhydrous silicon dioxide, magnesium stearate, methylhydroxypropylcellulose, microcrystalline cellulose, sodium starch glycolate;
• Cream: sodium hydroxide, benzyl alcohol, sorbitan stearate, stearyl alcohol, cetyl palmitate, cetyl alcohol, isopropyl myristate, polysorbate 60, purified water;
• Spray: ethanol 96%, macrogol cetostearate, propylene glycol, water.

pharmachologic effect

Lamisil is an antifungal agent. Its active substance terbinafine belongs to the group of allylamines, which have a wide spectrum of action against fungi. The following types of fungi that cause diseases of the skin, hair and nails are sensitive to it: yeast fungi Pityrosporum and Candida albicans, fungi Microsporum (Microsporum canis), Trichophyton (for example, Trichophyton verrucosum, Trichophyton tonsurans, Trichophyton violaceum, Trichophyton rubrum, Trichophyton mentagrophytes) , Epidermophyton floccosum.

When used in low concentrations, terbinafine has a fungicidal effect against some dimorphic and mold fungi, as well as dermatophytes. This compound is characterized by fungicidal or fungistatic activity against yeast fungi.

Terbinafine specifically inhibits the biosynthesis of sterols in the cell in the early stages. Deficiency of ergosterol and accumulation of squalene in intracellular cavities lead to the death of fungal cells. The mechanism of action of Lamisil is to inhibit the enzyme squalene epoxidase in the cell membrane of the fungus.

When taken orally, concentrations of the drug accumulate in the skin, hair and nails sufficient to provide a fungicidal effect. When applied topically, Lamisil is also characterized by a broad spectrum of antifungal activity.

Terbinafine does not affect the cytochrome P450 system, and therefore does not affect the metabolism of hormones and other drugs.

Pharmacodynamics and pharmacokinetics

When taking Lamisil tablets orally, terbinafine is absorbed relatively quickly: the level of absolute bioavailability of the substance, associated with the “first pass” effect, is about 50%. After oral administration of a dose of 250 mg, the maximum concentration of terbinafine in plasma is observed after 90 minutes. At the same time, the level of the substance in the blood increases with regular use of the drug.

The bioavailability of terbinafine depends to a small extent on food intake, so dose adjustment of the drug when taken with food is not required.

Terbinafine is 99% bound to plasma proteins. It quickly penetrates the dermal layer of the skin and concentrates in the lipophilic stratum corneum. There is a high concentration of terbinafine in areas of the skin with a large number of sebaceous glands, hair follicles, and hair. The active component of the drug is present in the nail plates in the first weeks after the start of therapy.

Terbinafine is rapidly metabolized to form metabolites that do not demonstrate antifungal activity and are excreted primarily through the kidneys.

When Lamisil cream or spray is applied externally, the absorption of terbinafine is less than 5%. There is a slight systemic effect of the drug.

Features of treatment during pregnancy and lactation

As for clinical experience with Lamisil, there are clear limitations. Therefore, if you cannot do without this remedy, the medication is taken under the close supervision of a doctor and only after his permission.

A component such as terbinafine will be excreted in mother's milk. But it cannot be said that Lamisil is 100% a destructive medicine for a child. This is due to the fact that the systemic penetration of this substance through a woman’s skin, if we talk about external use, is not so significant.

Indications for use

The use of all forms of the drug is indicated for the treatment and prevention of skin diseases caused by fungal infections:

• Dermatomycosis of smooth body skin (tinea corporis), caused by dermatophytes of the Trichophyton type, including T. rubrum, T. verrucosum, T. mentagrophytes, T. violaceum, Epidermophyton floccosum, Microsporum canis;
• Mycosis of the feet (tinea pedis), peeling of the skin and itching, cracks, keratinization (due to foot fungus);
• Inguinal athlete's foot (tinea craris);
• Yeast infections of the skin, mainly caused by fungi of the genus Candida (including Candida albicans), including diaper rash.

In addition, Lamisil is prescribed:

• Tablets: for the treatment of onychomycosis caused by dermatophyte fungi and mycosis of the scalp;
• Cream and spray: for the treatment of pityriasis versicolor (Pityriasis versicolor), caused by dimorphic fungi (Malassezia furfur).

Lamisil for fungus

This medication belongs to the pharmacological group of antifungal agents and has antimicrobial and antiseptic properties. Lamisil reduces the severity of unpleasant symptoms of fungal infections, has a fungicidal and anti-inflammatory effect, is suitable for use for most skin diseases, and in the form of a cream is intended for everyday external use. Lamisil cream can be an independent medicine, but it is much more effective to use it in a complex regimen.

Composition and release form

Lamisil for fungus has several forms of release, including tablets, spray, solution, ointment and cream. In the last two cases, we are talking about local use for fungal skin lesions of various etiologies. The cream has a uniform consistency and a specific smell. The drug Lamisil itself is a combination drug, it has a unique chemical composition with components that enhance the therapeutic effect of each other. All active ingredients are presented below:

How the drug works

As an active component, terbinafine has a destructive effect against a wide range of pathogenic fungi, including Candida. In addition, it has a stable fungicidal and fungistatic effect against molds and dimorphic fungi, dermatophytes. According to its pharmacological properties, it belongs to the group of allylamines.

According to the instructions, 10 mg of terbinafine slows down the metabolism of pathogenic flora, disrupts the integrity of membranes and promotes productive excretion from the body. Lamisil does not have toxic properties because, due to external use, it does not penetrate the systemic bloodstream. Productive absorption of the cream into damaged skin provides a stable therapeutic effect that lasts for a day or more.

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Indications for use

Lamisil is recommended for fungal diseases of various etiologies; it can complement oral administration of tablets with an antifungal effect. The main medical indications for the use of this cream are the following diagnoses and clinical pictures that a patient may encounter at any age:

• mycosis of the foot;
• diaper rash of various etiologies;
• fungal infections caused by increased activity of dermatophytes;
• athlete's foot inguinal;
• pityriasis versicolor;
• dermatomycosis;
• groin skin infections.

Contraindications

The use of all forms of Lamisil is contraindicated in case of hypersensitivity to terbinafine or to the auxiliary components of the drug.

You can't take pills:

• Pregnancy period (except for special cases when the expected clinical effect exceeds the potential threat to the fetus);
• Breastfeeding period.

Lamisil should be prescribed with caution:

• Tablets: in case of impaired renal function (creatinine clearance less than 50 ml/min), chronic or active liver diseases;
• Cream and spray: for liver and/or kidney failure, chronic alcoholism, tumors, suppression of bone marrow hematopoiesis, metabolic diseases, occlusive pathologies of the vessels of the extremities, during pregnancy.

Age restrictions for use:

• Tablets: children under 2 years of age;
• Cream: children under 12 years of age;
• Spray: children under 2 years old.

Lamisil cream price

The cost of the drug is not affordable for all patients. Lamisil cream is often shown in commercials, so we can say with confidence that it is a “promoted brand.” To save at least a little on such a mandatory purchase, it is recommended to use the services of online pharmacies and make a virtual order. The cream will be delivered by courier within 1-2 days. If there is no time to wait, here are the approximate prices of the medicine in Moscow:

Instructions for use of Lamisil: method and dosage

Tablets Take orally 1 time per day. The dose and duration of therapy are prescribed by the doctor based on clinical indications and the patient’s condition. Recommended daily dosage: for adult patients – 1 tablet; for children weighing: up to 20 kg - ¼ tablet, from 20 to 40 kg - ½ tablet, above 40 kg - 1 tablet. The drug is well tolerated in children. Recommended duration of taking the tablets: mycosis of the scalp (more often observed in children) – 4 weeks; dermatomycosis of the feet (plantar, interdigital or sock-type) – from 2 to 6 weeks; dermatomycosis of the trunk and legs, skin candidiasis - 2-4 weeks; onychomycosis - from 6 to 12 weeks (on the hands - 6 weeks, on the feet - 12 weeks) or the period of growth of a new healthy nail (if the rate of nail growth is reduced, longer treatment may be required). In the absence of concomitant liver and/or kidney dysfunction, elderly patients do not require dose adjustment;

Cream for external use Apply a thin layer to a previously cleaned and dried affected area of ​​the body and rub into the skin with light movements, capturing adjacent areas. When treating diaper rash in the interdigital spaces, under the mammary glands, between the buttocks and in the groin area, the use of gauze bandages is recommended, especially when applying the cream at night. The frequency of procedures and the treatment period depend on the clinical indications: ringworm of the trunk, legs, feet - 1 time per day for 1 week, for ringworm of the feet aggravated by keratinization, cracks, peeling and itching of the skin - 1-2 times a day for 2 weeks; skin candidiasis – 1-2 times a day for 1-2 weeks; for tinea versicolor – 1-2 times a day for 2 weeks. If there are no signs of effect after 1-2 weeks of therapy, you should consult a doctor to verify the diagnosis;

Spray for external use Apply by spraying onto previously cleaned and dried affected and adjacent areas of the body until the skin is thoroughly moisturized. Treatment period and frequency of spraying: for dermatomycosis of the feet, legs and torso – 1 week, 1 time per day; for tinea versicolor – 1 week, 2 times a day; for inguinal epidermophytosis, diaper rash - 1 week, 1 time per day.

Gel

Lamisil Dermgel can be used by adults or children, but only those over 12 years of age. The drug is used once a day, regardless of the indications and their manifestations. As in the case of feet, before applying the product to the skin, it should be thoroughly cleaned and dried.

But in this case, the gel will need to be rubbed in, otherwise the effect will not be so noticeable. Almost always, the course of treatment lasts no more than 1 week. If any unforeseen circumstances arise, adjustments occur only through the treating dermatologist.

Side effects

Despite the fact that Lamisil tablets are generally well tolerated by patients, their use can cause side effects:

• Digestive system: very often - nausea, loss of appetite, feeling of fullness in the stomach, dyspepsia, mild abdominal pain, diarrhea;
• Hematopoietic system: very rarely - neutropenia, agranulocytosis, pancytopenia, thrombocytopenia;
• Hepatobiliary system: rarely - hepatobiliary dysfunction (usually cholestatic in nature), including cases of severe liver failure (including fatal or requiring liver transplantation), usually in patients with serious concomitant systemic pathologies;
• Immune system: very rarely - anaphylactoid reactions (including angioedema), lupus erythematosus (cutaneous and systemic);
• Musculoskeletal system: very often – myalgia, arthralgia;
• Nervous system: often – headache; sometimes - disturbance or loss of taste (after discontinuation of treatment, restoration of taste buds occurs within a few weeks); very rarely - paresthesia, dizziness, hypoesthesia; in some cases – weight loss due to a decrease in food intake;
• From the subcutaneous tissue and skin: very often - minor skin reactions in the form of rash and urticaria; very rarely - toxic epidermal necrolysis, Stevens-Johnson syndrome and other severe skin reactions, exacerbation of psoriasis or psoriasis-like skin rashes; very rarely - hair loss;
• Other: very rarely – feeling of fatigue.

According to the instructions, Lamisil in the form of cream and spray can cause the following undesirable effects:

• Local reactions: burning or itching sensation, redness;
• Other: development of allergic reactions.

Overdose

While taking the drug Lamisil, an overdose usually develops when using a dosage of 3-5 g. In this case, the patient will suffer from the following symptoms:

1. constant nausea accompanied by pain in the stomach;
2. dizziness;
3. constant headaches;
4. general weakness;
5. a strong feeling of fatigue, even with moderate exertion.

If a patient experiences these symptoms associated with taking the drug, he should immediately contact a specialist, who should take all measures to quickly rid the body of the components of the drug. If the intensity of the manifestations is moderate, it will be enough to use activated carbon. But in more complex cases, gastric lavage will be required.

special instructions

Terbinafine suppresses the metabolism of tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers, monoamine oxidase type B inhibitors, class 1C antiarrhythmics, which is mediated by the enzyme CYP2D6. If the simultaneous use of these drugs with Lamisil tablets has a small range of therapeutic concentrations, it should be accompanied by constant monitoring.

If the use of tablets causes qualitative or quantitative changes in blood cells, it is necessary to determine the cause of the disturbances and reduce the dose of the drug, if necessary, consider its discontinuation.

If the skin rash progresses while taking Lamisil tablets, therapy should be discontinued.

If the effect of the tablets causes dizziness, then while taking them, patients are advised to temporarily stop driving vehicles and machinery.

The use of cream and spray reduces the severity of clinical manifestations after several days of treatment. Premature cessation and irregular use may cause recurrence of infection.

Lamisil cream and spray are intended for external use only. Do not allow them to get into your eyes, as this may cause irritation. In case of accidental contact with the drug, the eyes should be immediately rinsed with running water, and if persistent irritation develops, contact a specialist.

If allergic reactions develop during the use of a cream or spray, the medications must be discontinued.

If there is no therapeutic effect after 1 week of using the spray, it is necessary to clarify the diagnosis.

Since the presence of alcohol in the spray can cause irritation, care must be taken when spraying it onto affected areas of the skin.

Do not allow the spray to enter the respiratory tract.

When treating large areas of fungal infections of the body, tubes of 30 g of cream or 30 ml spray bottles should be used.

The spray does not affect the patient's ability to drive vehicles and machinery.

Solution

If an adult patient or a teenager over 15 years of age contacts the doctor, he advises them to apply Lamisil solution once to both feet, even if the fungal infection affects only one of them. Only in this case the patient can count on getting rid of the pathology in full. This feature is due to the fact that the microbes may already be on the other leg, but at the moment their vital activity is not accompanied by visual deviations.

Before applying this product to the affected areas, you must thoroughly wash and dry both feet and hands. To begin with, the solution is applied evenly to all areas between the fingers, as well as around this area. Next you need to move on to the sole and side of the foot. In this case, you should not try to save the solution next time. In order for the medicine to work and relieve the patient of the problem as quickly as possible, a fairly large amount of the drug will be required.

It is very important to treat both feet equally well, even if one of them does not yet have visible symptoms. After the procedure is completed, you should wash your hands well. The patient should remember that Lamisil solution is not recommended to be rubbed vigorously into the affected skin, nor to be reapplied.

Drug interactions

Cimetidine may increase the plasma concentration of terbinafine or enhance its effect.

Rifampin can weaken the effect of terbinafine or reduce its plasma levels by possibly increasing the clearance of terbinafine by up to 100%.

If it is necessary to simultaneously take metabolic inducers and cytochrome P450 inhibitors with Lamisil tablets, consider adjusting the dose of terbinafine.

The effect of terbinafine should be taken into account when taking Lamisil tablets simultaneously with drugs whose metabolism is carried out with the participation of the cytochrome P450 system. These drugs include terfenadine, triazolam, tolbutamide, and oral contraceptives. The exception is for drugs metabolized with the participation of CYP2D6.

Tablets when combined with digoxin or antipyrine do not affect their clearance; when combined with caffeine, they enhance its effect.

If the simultaneous use of tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers, monoamine oxidase type B inhibitors and antiarrhythmic drugs of class 1A, 1B and 1C is limited to a small range of their therapeutic concentrations, then terbinafine may suppress their metabolism.

Lamisil reduces the clearance of desipramine, weakens the effect of cyclosporine, reducing its concentration in the blood plasma.

The interaction of the cream and spray with other medications is unknown.

Terms and conditions of storage

The drug Lamisil in any form of release must be stored in a place where it is not exposed to direct sunlight. It is also worth taking care of the temperature indicators; in no case should they exceed 30 degrees.

This product should not be placed in the refrigerator, as it should not be exposed to cold air. If for any reason the drug is accidentally frozen, it is prohibited from using it in the future.

As for the shelf life, Lamisil tablets, as well as cream, can be stored for up to 5 years, the product in the form of a spray - no more than 3 years.

Reviews about Lamisil

Reviews about Lamisil are mostly positive. Despite the relatively high cost of the drug, it is considered an effective treatment for nail fungus. Within a few days after the start of treatment, the patients' condition improved. The desired result can be most quickly achieved by combining tablets with the use of Lamisil cream or spray. However, in the treatment of nail fungus and other fungal diseases, the use of only local forms of the drug is also successful.

There are also a few negative reviews about the lack of effectiveness of the drug.

Analogs of Lamisil tablets

If the patient needs to select analogues of Lamisil in the form of a spray, he can purchase products such as Termicon, Terbinafine, Fungoterbin or Lamicon. As for analogues of Lamisil gel or lotion, the same drugs can be used to treat fungus, but only after a visit to the doctor.

You can replace Lamisil cream with medications such as Fungoterbin, Exifin, or Atifin. All patients can purchase these drugs at any pharmacy or online store without presenting a prescription from a doctor. Although Lamisil tablets are a prescription drug, this will not be an obstacle to such a purchase.