Question

A 60 year old man asks the Nurse Practitioner to prescribe Terbinafine to treat his onychomycosis. What should be considered prior to prescribing this medication ? What medical conditions would be considered a contraindication for prescribing Terbinafine?

Answer 1

The medical conditions to be considered before prescribing terbinafine are

Terbinafine tablets are contraindicated in patients with:

• Chronic ​or active liver disease
• History of allergic reaction to oral Terbinafine because of the risk of anaphylaxis
• There are also drug interactions like
• Terbinafine is an inhibitor of the CYP450 2D6 isozyme. Drugs predominantly metabolized by the CYP450 2D6 isozyme include the following drug classes: tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers, antiarrhythmics class 1C (e.g., flecainide and propafenone) and monoamine oxidase inhibitors Type B. Coadministration of Terbinafine tablets should be done with careful monitoring and may require a reduction in dose of the 2D6-metabolized drug.