CLINICAL USE

Antifungal agent:Fungal infections of the skin and nails

DOSE IN NORMAL RENAL FUNCTION

250 mg dailyTopical: apply once or twice daily

PHARMACOKINETICS

  • Molecular weight                           :291.4; (327.9 as hydrochloride)
  • %Protein binding                           :99
  • %Excreted unchanged in urine     : 0
  • Volume of distribution (L/kg)       :6–111, 2
  • half-life – normal/ESRD (hrs)      :17–36/Increased

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : 100% on alternate days
  • 10 to 20     : 100% on alternate days
  • <10           : 100% on alternate days

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HD                     :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Unknown dialysability. Dose as in GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • None known

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral, topical

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    Terbinafine is hepatically metabolised to two major metabolites, 80% of which are renally excretedLittle information is available regarding the handling of terbinafine in renal failure but clearance is reduced by 50% if GFR<50 mL/min In CKD 5 use with caution and monitor for side effects .

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