Exifin

Exifin is an antifungal drug.

Indications Exifin

It is indicated for the elimination of fungi on the skin, hair, and nails (caused by the action of dermatophytes).

Release form

Produced in tablet form - 4 tablets per blister. One package contains 4 blister plates.

Pharmacodynamics

The active substance of the drug is terbinafine hydrochloride - a synthetic element in the group of allylamines, and has a wide range of antifungal effects. At a weak concentration, terbinafine acquires a fungicidal activity against individual molds, as well as dimorphic fungi, and also to dermatophytes. Regarding yeast fungi, the substance has fungistatic or fungicidal effect (depends on the type of fungus).

The mechanism of drug exposure is due to its ability to inhibit the early stages of binding of sterols inside the membranes of fungal cells. The substance contributes to the deficit of ergosterol, as well as the accumulation of squalene within the cells - as a result, this causes the death of the fungus.

Pharmacokinetics

After oral administration, the substance accumulates in the hair follicles, skin, and nail plates. The bioavailability index of drugs is increased if it is taken with food. After 2 hours after use, the concentration of the drug in the plasma becomes maximum.

More than 99% of the dosage of the active ingredient is synthesized with a plasma protein.

Metabolism of terbinafine is carried out in the liver. As a result, derivatives that do not have pharmacological activity are formed.

The excretion of the substance is mainly carried out through the kidneys in the form of derivatives. The half-life is 30 hours.

Noticeable differences in the pharmacokinetics of the substance, depending on the age group of the patient, have not been established. Disorders in the liver or kidneys can cause a change in the rate of excretion of the component from the body.

Dosing and administration

You need to drink tablets before meals or after it. Dosages, the scheme of use, as well as the duration of drug use are appointed by the treating doctor, which takes into account the nature of the pathology, as well as its severity.

For children weighing 40+ kg, as well as adults in the treatment of fungal infections, it is usually prescribed the use of the 1st pill of medication per day.

The duration of treatment for the removal of fungal infections on the scalp is equal to 1 month, and when eliminating ringworm on smooth skin or candidiasis on the skin is 0.5-1 month.

To eliminate mycosis on the feet, it is required to use the drug for 2-6 weeks (the exact period depends on the skin condition, as well as the pathogen that provoked the disease).

The duration of therapy with onychomycosis (fungus, affecting the nail plates) is 6-12 weeks. The duration of the course usually depends on how fast the nails grow, because, as with such diseases, it is usually recommended to use the medicine until the healthy nail completely grows.

Clinical manifestations of the disease can disappear after a few days after the start of therapy, but it is necessary to continue the use of tablets throughout the period appointed by the doctor. If you stop the therapy prematurely, or take irregular tablets, relapse of the pathology is possible.

If the medicine is taken for a long time, it is required to monitor the parameters of the peripheral blood, as well as for the hepatic function.

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Use Exifin during pregnancy

Pregnant women should not take medicine.

During the lactation, the use of terbinafine is also not recommended. If you can not refuse to take drugs, it is necessary to abolish breastfeeding for the period of treatment.

Contraindications

The drug can not be taken if hypersensitivity to terbinafine or other elements of drugs.

Contraindication is the presence of the patient's liver pathologies (also if they are in history), and in addition to renal failure (if the rate of cleavage of creatinine is below 50 ml / min).

It is forbidden to prescribe drugs to children who have not reached the age of 12 years (the weight of the child should not be less than 40 kg).

Side effects Exifin

The use of a drug can provoke such side effects:

• organs of the hematopoiesis system: thrombocyto-, pancito-and neutropenia, as well as agranulocytosis;
• organs of the National Assembly: the appearance of dizziness and headaches, and in addition to paresthesia or hypesthesia and a disorder of taste buds;
• organs of the digestive system: deterioration of appetite, dyspepsia, nausea, abdominal pain, stool disorders, as well as a feeling of fullness of the stomach;
• liver, as well as organs of ZHVP: increased activity of hepatic enzymes, the development of hepatitis or jaundice. There was a single decrease in hepatic activity (up to the development of liver failure with a subsequent fatal outcome) in people suffering from a disorder in the work of this organ (but it was not possible to confirm the connection between death due to hepatic insufficiency and terbinafine use);
• allergies: the development of urticaria, Lyell's syndrome, erythema multiforme, and the acute form of generalized exanthematous pustules and angioedema, and in addition to lupus erythematosus;
• other: myalgia and arthralgia, severe fatigue, and in addition, exacerbation of psoriasis.

Occasionally, a strong loss of hair was observed, but at the same time, it was not possible to bind alopecia to the use of tablets.

If the patient exhibits side effects, it is necessary to consult a doctor to determine the advisability of further treatment with Exifin. With a worsening of the liver, changes in activity, as well as the level of liver enzymes, and besides, with dyspepsia, constant nausea and changes in the parameters of the blood cells, you should cancel the use of the medicine.

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Overdose

Exxin use at elevated dosages can cause symptoms such as nausea along with vomiting, epigastric pain, dizziness with headaches, rashes on the skin, and polyuria.

The medicine does not have a specific antidote. If there are overdose symptoms, it is necessary to cancel the drug and perform treatment aimed at eliminating the symptoms.

Interactions with other drugs

Medications that slow or induce enzymes entering the hemoprotein P450 system in combination with Exifin are able to change the concentration of the unchanged active substance of the latter inside the plasma. If you can not refuse the use of such drugs in combination, you need to monitor the indicators of terbinafine, as well as adjust the dosage of Exifin, if necessary.

The combination of terbinafine with warfarin can change the prothrombin time, weaken the effectiveness of the drug, and in addition increase the risk of bleeding. If long-term use of these drugs is required together, it is necessary to monitor prothrombin time, as well as adjust the dosages of warfarin.

The combination with rifampicin increases the coefficient of terbinafine purification by 100%.

With the simultaneous use of Exifin and drugs, the metabolism of which occurs with the enzymes of the hemoprotein P450 system, some modification of the pharmacokinetic properties of the latter is possible.

The drug does not affect the pharmacokinetics of antipyrin, as well as digoxin.

Terbinafine reduces the caffeine purification rate by 19% (parenteral forms of caffeine).

Combination of the drug with tricyclics, β-adrenoreceptor blockers, selective inhibitors of reverse serotonin capture, and also with antiarrhythmic drugs (categories 1A, 1B, 1C) and MAO inhibitors (type B) may slightly increase the concentration of the above drugs inside the plasma.

With the simultaneous use of Exifin with desipramine, the purification rate of the latter decreases by 82%.

As a result of the combination with terbinafine, a decrease in the coefficient of clearance of cyclosporine (by 15%) is also observed.

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Storage conditions

The drug is required to be kept in the usual conditions for medicines, inaccessible to young children. Temperature - in the range of 15-25 ^{on the} C

Shelf life

Exifin is allowed to be used for 3 years from the date of its release.