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Itraconazole is authorised in the world under the following brand names: Hyphanox, Itrizole, Oriconazole, Sporal, Sporanos, Sporanox, Sporonox, Triasporn.
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Terbinafine is an infective / antifungal agent that inhibits squalene epoxidase, resulting in ergosterol deficiency and a corresponding accumulation of squalene within the fungal cell leading to fungal cell death. It is indicated in the treatment of onychomycosis of the toenail or fingernail caused by dermatophytes. Topical: used in interdigital tinea pedis, tinea cruris, or tinea corporis caused by E. floccosum, T. mentagrophytes, or T. rubrum.
Terbinafine (Lamisil) 250mg tablets is well absorbed, but bioavailability is decreased to about 40% because of first-pass metabolism in the liver. Proteins bind more than 99% of the drug in plasma. Drug accumulates in skin, nails, and fat. The initial half-life is about 12 hours but extends to 200 to 400 hours at steady state. Drug can be found in plasma for 4 to 8 weeks after prolonged therapy. Terbinafine is not recommended in patients with marked azotemia or hepatic failure, because in the latter condition, terbinafine plasma levels are increased by unpredictable amounts. Rifampin decreases and cimetidine increases plasma terbinafine concentrations. The drug is well tolerated, with a low incidence of gastrointestinal distress, headache, or rash. Rarely, hepatotoxicity, severe neutropenia, Stevens-Johnson syndrome, or toxic epidermal necrolysis may occur. The drug is contraindicated in pregnancy. It is recommended that systemic terbinafine therapy for onychomycosis be postponed until after pregnancy is complete. Its mechanism of action is probably inhibition of fungal squalene epoxidase, blocking ergosterol biosynthesis.
Terbinafine (Lamisil) 250mg, given as one 250-mg tablet daily, is at least as effective for nail onychomycosis as 200 mg daily of itraconazole, and slightly more effective than pulse itraconazole therapy (see above). Duration of treatment varies, with the site being treated but typically is 3 months. Although not approved for this use, terbinafine (250 mg daily) also is effective in ringworm elsewhere on the body. No pediatric formulation is available, so there is little experience with the drug in tinea capitis, usually a disease of children.
Terbinafine (Lamisil) 1% cream or spray is applied twice daily and is effective in tinea corporis, tinea cruris, and tinea pedis. Terbinafine is less active against Candida species and Malassezia furfur, but the cream also can be used in cutaneous candidiasis and tinea versicolor. In European studies, oral terbinafine has appeared to be effective in treatment of ringworm, and in some cases of onychomycosis. The systemic use of terbinafine is discussed above.
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Synonyms of Itraconazole *:
ITC, ITCZ, ITR, Itraconazol [Spanish], itraconazole, Itraconazolum [Latin], ITZ
* Official titles and synonyms used in the British, European, and US Pharmacopoeias. INNs in the other main official languages (French, Latin, and Spanish) have also been included in the list of synonyms where these differ from the English INN.
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Dosage forms of Itraconazole:
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Therapeutic classes of Itraconazole:
Antifungal Agents, Antifungals, Antiprotozoal Agents, Antiprotozoals
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