Experiences with
Terbinafine

Terbinafine is an antifungal medicine. It's used to treat skin infections caused by a fungus (yeast), including:

athlete's foot
fungal nail infections
ringworm
jock itch (sometimes called dhobie itch), an infection in the groin area
pityriasis versicolor – this causes small patches of scaly and discoloured skin, often on your back, chest, upper arms, neck and stomach
candidal skin infections

Terbinafine comes as a cream, gel or spray for treating athlete's foot, ringworm, jock itch, pityriasis versicolor and candidal skin infections. There's also a liquid (solution) for athlete's foot. You can buy these from a pharmacy or shop.

It also comes as tablets for treating fungal nail infections and other fungal infections. Your doctor may recommend tablets if they think creams, gels, sprays or solution are not likely to work. Terbinafine tablets are only available on prescription.

Who can take or use terbinafine

Terbinafine tablets, cream and gel can be prescribed for adults and children aged 1 year old and over.

The cream, gel and spray that you can buy in a pharmacy or shop are suitable for people aged 16 years old and over.

The solution is only suitable for adults aged 18 years old and over.

Who may not be able to take or use terbinafine

Terbinafine is not suitable for some people. To make sure it's safe for you, tell your doctor or pharmacist if you have ever had an allergic reaction to terbinafine or any other medicine.

To make sure the tablets are safe for you, tell your doctor or pharmacist if you:

have ever had liver or kidney problems
are pregnant, trying to get pregnant or are breastfeeding

Dosage

Your doctor or pharmacist will tell you how much terbinafine to use and how long you need to use it for, depending on your infection.

If you're using the cream, gel or spray, you'll usually need to use it once or twice a day.

If you're using the solution, you only use it once.

If you're taking the tablets, the usual dose is 1 tablet, taken once a day. You'll usually take the tablets for 2 to 6 weeks. This depends on the type of infection you have and how serious it is.

How to use terbinafine cream or gel

Put the cream or gel on the infected area once or twice a day for 1 to 2 weeks.

Wash your hands before using the cream or gel.
Wash and dry the infected skin where the cream or gel will go. If you're treating your feet, it's also important to wash and dry between your toes first.
Unscrew the cap.
Squeeze out a small amount of the cream or gel onto your finger (enough to put a thin layer on your skin).
Gently rub it into the infected areas. Avoid putting it near your mouth, lips and eyes.
Replace the cap.
Wash your hands.

If you're using the cream or gel on the area between your toes, or on your bottom or groin, you can cover the skin with a clean strip of gauze afterwards. This type of light dressing is available to buy at pharmacies and is especially helpful to use at night.

How to use terbinafine spray

Put the spray on the infected area once or twice a day for 1 to 2 weeks.

Wash your hands before using the spray.
Wash and dry the infected skin before using the spray. If you're treating your feet, it's also important to wash and dry between your toes first.
Take the cap off and prepare the spray by pressing the top of the spray down once or twice.
Hold the bottle about 10cm away from the infected area and spray until your skin is thoroughly wet. Avoid getting it near your mouth, lips and eyes.
Replace the cap.
Wash your hands.

If you're using the spray on the area between your toes, or on your bottom or groin, you can cover the skin with a clean strip of gauze afterwards. This type of light dressing is available to buy at pharmacies and is especially helpful to use at night.

How to use terbinafine solution (Lamisil Once)

The solution for athlete's foot comes in a tube with a nozzle. It's a single treatment that you only use once.

Use the solution on both feet even if one of them looks fine. If one foot looks less infected than the other, put the solution on the less infected foot first.

Use the solution after a shower or bath. Before using the solution, make sure your feet are dry, including between your toes.
Remove the cap.
Put the solution all over your toes, including between each toe, and on the sole, top and sides of your foot. This should use about half the tube. Finish treating this foot before treating the other.
Do not rub or massage the solution in.
Leave the solution to dry on your feet for 1 to 2 minutes.
Replace the cap and throw the tube away.
Wash your hands.
Put on your normal shoes and socks.

Do not wash or splash your feet with any water for 24 hours after using the solution.

After 24 hours, wash your feet with warm, soapy water in the bath or shower and gently pat them dry.

How to take terbinafine tablets

Swallow the tablet whole with a drink of water.

You can take terbinafine tablets with or without food. It's best to take your tablets at the same time each day.

If you have a fungal nail infection, you'll probably need to take the tablets for several months. These infections take a while to clear.

How long to take or use it for

If you're using the cream, gel or spray, you'll usually need to use it for 1 to 2 weeks. Talk to your doctor if your symptoms do not get better within 2 weeks.

If you're taking the tablets, you'll usually take them for:

2 to 4 weeks if you have jock itch
2 to 6 weeks if you have athlete's foot
4 weeks if you have ringworm
6 weeks to 3 months (sometimes longer) if you have a fungal nail infection

It's important to keep taking or using terbinafine until you finish the course, even if your symptoms get better. Follow the instructions from your doctor or on the leaflet that comes with the medicine.

If you stop using your terbinafine too soon, or if you do not use it as recommended, the fungal infection could come back.

Talk to your doctor if you're thinking of stopping your treatment for any reason.

If you forget to take it or use it

If you forget to use your terbinafine cream, gel or spray, just use it as soon as you remember and then keep following your usual routine.

If you forget to take a terbinafine tablet, take it as soon as you remember, unless it's nearly time for your next dose. In this case, just skip the missed dose and take your next one at the usual time. Then carry on until you have finished the course.

Do not take 2 doses to make up for a missed dose.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember your medicines.

If you take or use too much

If you use too much terbinafine cream, gel or spray or use it more often than you need to, it may make your skin irritated or red. If this happens, use less of the cream, gel or spray the next time.

Taking 1 or 2 extra terbinafine tablets is unlikely to harm you.

If you take more than this, you may get side effects including stomach pain, feeling or being sick, diarrhoea, headache or feeling dizzy.

you take a lot of terbinafine tablets at the same time (4 or more) even if you have no side effects
you take 2 or more terbinafine tablets and have side effects

Call 111 or go to 111.nhs.uk . Call 111 if you need advice for a child under the age of 5 years.

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the terbinafine packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

This common side effect of terbinafine cream, gel, spray or solution happens in more than 1 in 100 people. There are things you can do to help cope:

If you're using the cream, gel or spray, try using smaller amounts or stop using it completely. Avoid clothes that irritate your skin, such as wool or synthetic fabrics. If the rash is itchy, pat or tap the area rather than scratching.

It may help to take an antihistamine, which you can buy from a pharmacy. Check with the pharmacist to see what type is suitable for you.

These common side effects of terbinafine tablets happen in more than 1 in 100 people. There are things you can do to help cope with them:

Avoid clothes that irritate your skin, such as wool or synthetic fabrics. If the rash is itchy, pat or tap the area rather than scratching.

It may help to take an antihistamine, which you can buy from a pharmacy. Check with the pharmacist to see what type is suitable for you.

Rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller if you need one.

Talk to your doctor if the headaches last longer than a week or are severe.

Drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take contraceptive pills and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Stick to simple meals and do not eat rich or spicy food. If you're being sick, try small, frequent sips of water to avoid dehydration. It might help to take your tablets after a meal or snack.

If you take the combined contraceptive pill or the progestogen-only pill, and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Your appetite should get better as your body gets used to the medicine. It may also help to eat smaller and more frequent meals and to eat foods you really enjoy.

If your appetite does not improve or you lose a lot of weight, ask your doctor for advice.

This usually gets better gradually after you stop taking terbinafine. Speak to a doctor if it does not get better.

It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help.

If you're in a lot of pain, speak to a doctor or pharmacist.

Try not to drink too much alcohol or drinks containing caffeine, such as tea, coffee, cola or energy drinks. Avoid rich, spicy or fatty foods.

If indigestion bothers you mostly at night, stop eating 3 to 4 hours before your bedtime, and try propping your head and shoulders up in bed.

Ask a pharmacist to recommend an antacid.

Ask a pharmacist to recommend a painkiller if you need one. Talk to your doctor if the pain lasts longer than a week or is severe.

Stop what you're doing and sit or lie down until you feel better. Do not drive, cycle or use tools or machinery if you're feeling dizzy.

Talk to your doctor if this bothers you.

Talk to your pharmacist or doctor if the advice on how to cope does not help and these side effects bother you or do not go away.

Serious side effects

Some people can have serious side effects when using or taking terbinafine. These happen in less than 1 in 1,000 people.

If you're prescribed tablets, stop taking them and call a doctor or call 111 immediately if:

the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin, or if you have pale poo and dark pee – these can be signs of liver problems
you bruise more easily or get infections more easily – these can be signs of a blood disorder
you have a high temperature with a rash, itchy skin and unusual tiredness, or if you notice any purple spots under your skin – these can be signs of an inflammation of the blood vessels called vasculitis
you get severe pain near the top of your stomach that spreads to your back – this can be a sign of an inflamed pancreas (acute pancreatitis)
your muscles feel weak or painful, or your pee is a dark red-brown – these can be signs of muscle problems

Serious allergic reaction

It happens rarely but it is possible to have a serious allergic reaction (anaphylaxis) to terbinafine.

Meds New IA (H4) - serious allergic reaction

If you take terbinafine tablets for a long time, there's a small chance that they can affect your liver. This happens to less than 1 in 1,000 people. Your doctor may ask you to have a blood test to check that your liver is working properly.

Other side effects

These are not all the side effects of terbinafine. For a full list, see the leaflet inside your medicine packet.

Terbinafine and pregnancy

Terbinafine tablets are not generally recommended in pregnancy.

There's no evidence that using terbinafine cream, gel or spray in pregnancy will harm your baby.

If you're pregnant or trying to get pregnant speak to your doctor about whether terbinafine is the right medicine for you.

Terbinafine and breastfeeding

If your doctor or health visitor says your baby is healthy, you can take or use terbinafine when you're breastfeeding.

Cream, gel, spray or solution

Terbinafine from the cream, gel, spray or solution is very unlikely to get into breast milk and will not cause any side effects in your baby.

Be careful that your baby does not come into contact with the areas of your body you have put it on. Wash your hands after you have used it and before picking up your baby. Do not put it on your breasts.

Tablets

There is not much information about how much terbinafine from the tablets passes into breast milk, but information shows that it's a very small amount. However, your doctor or pharmacist may recommend other antifungal medicines which might be better while breastfeeding.

If you do take terbinafine tablets while breastfeeding, talk to your health visitor, midwife, doctor or pharmacist as soon as possible if you have any concerns, including if your baby:

is not feeding as well as usual
has an upset stomach, such as being sick or diarrhoea
has signs of jaundice – these include yellowing of the whites of the eyes or the skin (this may be less obvious on brown or black skin), dark pee and pale poo
has a rash

Terbinafine and fertility

There is no evidence that terbinafine reduces fertility in either men or women.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

Terbinafine cream, gel, sprays and solution are generally OK to use when taking other medicines.

However, terbinafine tablets and some medicines can affect each other. If you're prescribed the tablets, tell your doctor if you're taking:

antidepressants
beta blockers for heart problems
oral contraception
amiodarone, to treat heart problems
ciclosporin, used after an organ transplant
cimetidine, to treat stomach problems such as indigestion
rifampicin, to treat bacterial infections
tamoxifen, to treat breast cancer
warfarin, to treat and prevent blood clots

These are not all the medicines that can affect terbinafine. For a full list, check the leaflet that comes with your medicine.

Taking terbinafine with painkillers

It's safe to take or use terbinafine with paracetamol, ibuprofen, diclofenac or naproxen.

However terbinafine tablets can affect:

codeine – terbinafine tablets can affect how well codeine works. If you notice your pain is not as well controlled as usual ask your doctor about other painkillers you could use
tramadol – terbinafine tablets can increase your chance of getting side effects from tramadol. Speak to your doctor if you get side effects or feel unwell in any other way

Mixing terbinafine with herbal remedies and supplements

There's not enough information to say that complementary medicines, herbal remedies and supplements are safe to take with terbinafine. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Meds New IA (H2) - Cautions with other medicines alert