Terbinafine

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

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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 .

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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