Medical expert of the article
New publications
Preparations
Terbinafine-ratiopharm
Last reviewed: 04.07.2025

All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Terbinafine-ratiopharm is an allylamine derivative with a broad spectrum of antifungal effects. The medication must be taken orally.
When administered in low concentrations, the drug exhibits fungicidal activity against yeast fungi, dermatophytes, and individual dimorphic fungi. The effect on yeast fungi is either fungistatic or fungicidal (determined by the type of fungus). [ 1 ]
The drug specifically slows down the early phase of sterol biosynthesis inside the fungal cell. [ 2 ]
Indications Terbinafine-ratiopharm
It is used for onychomycosis caused by the influence of dermatophytes.
In addition, it is prescribed for dermatomycosis (affecting the feet, trunk, shins and skin under the scalp) and epidermal infections associated with Candida fungi (in situations where the location of the lesion, its prevalence or detectability make oral treatment advisable).
Release form
The drug is released in tablets with a volume of 0.25 g - 14 pieces inside a blister pack; in a box - 1 or 2 such packages.
Pharmacodynamics
Terbinafine exerts a therapeutic effect by inhibiting squalene epoxidase inside the fungal cell wall. As a result, there is a deficiency of ergosterol, and squalene begins to accumulate inside the cells, resulting in the death of the fungal cell. The enzyme squalene epoxidase is not part of the structure of the hemoprotein P450, which is why terbinafine does not affect the processes of hormone metabolism or other medications.
Terbinafine demonstrates activity against dermatophytes of the genera Trichophyton, Microsporum, Epidermophyton and yeast-like fungi Candida (mainly against Candida albicans). [ 3 ]
Pharmacokinetics
After a single dose of 0.25 g terbinafine, the plasma level Cmax is determined approximately after 2 hours and is equal to 0.97 μg/ml. Intraplasmic synthesis with protein is 99%.
The drug quickly accumulates inside the keratinized lipophilic skin layer. The drug is secreted into the sebum, forming high levels inside the nails and hair follicles. Over the course of several initial weeks of therapy, the active ingredient accumulates inside the epidermis and nails in concentrations that lead to the development of a fungicidal effect.
The drug is involved in intrahepatic metabolism; most of the inactive metabolic components (71%) are excreted in the urine, and the remainder (22%) in the feces. The half-life is 11-17 hours. No accumulation occurs inside the body.
Terbinafine is secreted in breast milk.
In individuals with liver/kidney problems, the rate of excretion of the drug may be reduced.
Dosing and administration
Persons over 12 years of age, as well as adults, should take 0.25 g of the drug (1 tablet) once a day.
In case of onychomycosis, the course duration is 1.5-3 months and depends on the duration of the nail plate regrowth period. Sometimes, if the nail grows slowly, the therapeutic cycle may be longer. The length of the treatment period may also depend on other factors – the conduct of a concomitant treatment course, the patient’s age and the condition of the nails at the start of therapy. The clinical effect often develops after several months from the moment of mycological cure and completion of the treatment course, which is due to the fact that a healthy nail grows back.
Fungal infections affecting smooth skin: the duration of therapy for mycosis on the feet is 0.5-1.5 months, and for mycosis on other areas of the skin (shin, trunk) - 0.5-1 month. For mycosis of the skin under the hair, therapy lasts 1 month (but in cases where the causative agent of the infection is M. Canis, it can be longer).
Use in individuals with liver problems.
Because no studies have been conducted on the use of terbinafine in individuals with active or chronic liver disease, it is prescribed to this group only in situations where the beneficial effects are more likely to outweigh the possible risks.
Prescription for persons with renal dysfunction.
People with such problems (creatinine clearance <50 ml per minute or serum creatinine >300 μmol/l) are required to take half the standard dose, which is 0.5 tablets of 0.25 g (0.125 g terbinafine), 1 time per day.
- Application for children
There is no information regarding the oral use of the drug (0.25 g tablets) in pediatrics (under 12 years of age), which is why it is not prescribed to this age group, except in situations where the benefit from taking it is more likely than the risks of negative consequences. The duration of therapy and the portion size are determined by the child's weight (for example, with a weight of 20-40 kg, half of the adult portion is required).
Use Terbinafine-ratiopharm during pregnancy
Since there is no information regarding the safety of using Terbinafine-ratiopharm during pregnancy, it is prescribed only in situations where the likelihood of benefit is higher than the risk of complications.
Because terbinafine is excreted in breast milk, it should not be used during breastfeeding.
Contraindications
Contraindicated for use in case of severe intolerance to terbinafine hydrochloride or other components of the medication.
Side effects Terbinafine-ratiopharm
Main side effects:
- intolerance symptoms: urticaria and anaphylactic symptoms (nausea, decreased blood pressure, dyspnea and dizziness), epidermal manifestations (for example, TEN or SJS), photosensitivity and Quincke's edema may be observed;
- gastrointestinal tract disorders: bloating, heartburn, vomiting, stomach heaviness and taste disturbances (up to and including temporary loss of taste);
- liver disorders: hepatitis, hepatobiliary dysfunction, increased intrahepatic enzyme levels and jaundice;
- problems with hematopoietic activity: thrombocyto- or neutropenia and agranulocytosis;
- disorders of the nervous system: paresthesia, headaches, severe fatigue and sensory disturbances. Depression or fear are noted sporadically;
- other negative symptoms: myalgia, psoriasis, arthralgia, alopecia and menstrual irregularities.
Overdose
In case of poisoning, vomiting, dizziness, pain in the epigastric region, nausea and headaches are observed.
Gastric lavage is performed, activated charcoal is used, and symptomatic measures are taken.
Interactions with other drugs
Terbinafine has a strong inhibitory effect on the CYP2D6 enzyme, which should be taken into account when using Terbinafine-ratiopharm in combination with medications whose metabolism is developed with the help of the CYP2D6 enzyme.
Therefore, in cases where the patient is using antidepressants (MAOI-B, tricyclics and SIONS) or β-blockers, terbinafine should be used with extreme caution. Dosage adjustments may be necessary.
Terbinafine differs from azole antifungals in that it has virtually no effect on the ability to increase or slow down the clearance of drugs whose metabolism involves hemoprotein P450 (for example, tolbutamide with cycloserine and oral contraception). At the same time, the clearance rate of terbinafine may increase with the introduction of agents that increase the rate of metabolism (including rifampicin). At the same time, substances that slow down the activity of hemoprotein P450 (for example, cimetidine) also inhibit the metabolism of terbinafine. If it is necessary to combine such drugs, it may be necessary to change the dose of terbinafine.
Storage conditions
Terbinafine-Ratiopharm should be stored in a place inaccessible to small children. Temperature values - maximum 25°C.
Shelf life
Terbinafine-Ratiopharm can be used for a period of 36 months from the date of production of the pharmaceutical element.
Analogues
Analogues of the drug are Lamisil, Terbisil with Lamicon, Fungotek and Mikofin with Lamifen.
Attention!
To simplify the perception of information, this instruction for use of the drug "Terbinafine-ratiopharm" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.