Terbikill 15 Cream

Allylamine antifungal for:

• Fungal nail infections (onychomycosis) — tablets
• Ringworm of the body, groin and feet (tinea corporis, cruris, pedis) — cream/gel/spray or tablets for extensive infection
• Scalp ringworm (tinea capitis) in children — tablets (specialist)
• Cutaneous candidiasis and pityriasis versicolor — cream

Tablets (adults): 250 mg once daily.

• Fingernails: 6 weeks; toenails: 12 weeks (sometimes longer).
• Skin ringworm: 2–4 weeks; athlete's foot: 2–6 weeks.

Children (tinea capitis, 2 years+): under 20 kg 62.5 mg; 20–40 kg 125 mg; over 40 kg 250 mg once daily for 4 weeks.

Cream 1%: apply thinly once or twice daily for 1–2 weeks (athlete's foot between toes: 1 week); continue a few days after clearance.

• Nails may take months to look normal after treatment, as healthy nail grows out.

• Allergy to terbinafine
• Chronic or active liver disease (tablets)
• Severe kidney impairment (tablets)

Tablets — common: headache, stomach upset, diarrhoea, loss of appetite, rash, joint/muscle pain, taste disturbance or loss (may last weeks).

Rare but serious (tablets): liver failure (dark urine, jaundice, persistent nausea — stop and seek help), severe skin reactions, low blood counts, worsening of lupus or psoriasis, smell disturbance, depression.

Cream: redness, itching, burning.

• Liver function test before starting long courses of tablets; report signs of liver problems.
• Confirm nail fungal infection by testing before long treatment if possible.
• Keep cream away from eyes.

Tablets: avoid in pregnancy and breastfeeding. Cream: may be used in pregnancy on small areas if needed; do not apply to the breast while breastfeeding.

Tablets inhibit CYP2D6:

• Tricyclic antidepressants, SSRIs (paroxetine), beta-blockers (metoprolol), flecainide, propafenone, some antipsychotics (raised levels)
• Rifampicin (lowers terbinafine); cimetidine, fluconazole (raise it)
• Ciclosporin (levels may fall)
• Caffeine (cleared more slowly)

Headache, nausea, stomach pain, dizziness. Supportive care.

Store below 30°C.