Terabinafine adverse effects

Terbinafine is available in both oral and topical forms. Adverse effects include gastrointestinal upsets, rash, headache, and taste disturbances,diarrhea, dyspepsia, and nausea although its bioavailability is only 40 percent due to first-pass metabolism. Terbinafine is greater than 99 percent bound to plasma proteins. It is deposited in the skin, nails, and fat. Terbinafine accumulates in breast milk and should not be given to nursing mothers. A prolonged terminal half-life of 200 to 400 hours may reflect the slow release from these tissues. Oral terbinafine is extensively metabolized prior to urinary excretion Patients with either moderate renal impairment or hepatic cirrhosis have reduced clearance. Taste and visual disturbances have been reported as well as transient elevations in serum liver enzyme levels. Rarely, terbinafine may cause hepatotoxicity and neutropenia. Rifampin decreases blood levels of terbinafine, whereas cimetidine increases blood levels