Lamisil
Lamisil: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological action
- 3. Pharmacodynamics and pharmacokinetics
- 4. Indications for use
- 5. Contraindications
- 6. Method of application and dosage
- 7. Side effects
- 8. Overdose
- 9. Special instructions
- 10. Application in children
- 11. Pregnancy and lactation period
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price
Latin name: Lamisil
ATX code: D01AE15
Active ingredient: Terbinafine (Terbinafine)
Manufacturer: Novartis Consumer Health (Switzerland)
Description and photo update: 2019-31-07
Prices in pharmacies: from 350 rubles.
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Lamisil is an antifungal agent with fungistatic and fungicidal action.
Release form and composition
Dosage forms:
- Tablets: from white with a yellowish tinge to white, round biconvex, with a chamfer, smooth or rough surface, on the side with a dividing line there is an inscription around the circle of the LAMISIL 250 tablet (in blisters: 7 pcs., In a cardboard box 1 blister; 14 pcs., in a cardboard box 1 or 2 blisters);
- Cream for external use: homogeneous white structure with a characteristic faint odor (15 or 30 g in aluminum tubes, in a cardboard box 1 tube);
- Spray for external use: colorless or light yellow transparent liquid with a specific odor (15 ml or 30 ml in high density polyethylene bottles with a spray tip, 1 bottle in a cardboard box).
The active ingredient is terbinafine hydrochloride:
- 1 tablet - 250 mg;
- 1 g of cream - 10 mg;
- 1 g spray - 10 mg.
Auxiliary components:
- Tablets: colloidal anhydrous silicon dioxide, magnesium stearate, methylhydroxypropyl cellulose, microcrystalline cellulose, sodium glycolate starch;
- Cream: sodium hydroxide, benzyl alcohol, sorbitan stearate, stearyl alcohol, cetyl palmitate, cetyl alcohol, isopropyl myristate, polysorbate 60, purified water;
- Spray: ethanol 96%, macrogol cetostearate, propylene glycol, water.
pharmachologic effect
Lamisil is an antifungal agent. Its active substance terbinafine belongs to the group of allylamines, which have a wide spectrum of action against fungi. Fungi that cause diseases of the skin, hair and nails of the following species are sensitive to it: yeast fungi Pityrosporum and Candida albicans, fungi Microsporum (Microsporum canis), Trichophyton (for example, Trichophyton verrucosum, Trichophyton tonsurans, Trichophyton violaceum, Trichophyton ruble), Epidermophyton floccosum.
When used in low concentrations, terbinafine has a fungicidal effect against some dimorphic and mold fungi and dermatophytes. This compound is characterized by fungicidal or fungistatic activity against yeast fungi.
Terbinafine specifically inhibits the biosynthesis of sterols in the cell in the early stages. Ergosterol deficiency and the accumulation of squalene in the intracellular cavities lead to the death of fungal cells. The mechanism of action of Lamisil is to inhibit the enzyme squalene epoxidase in the cell membrane of the fungus.
When taken orally, the concentration of the drug is accumulated in the skin, hair and nails, sufficient to ensure the fungicidal effect. When applied topically, Lamisil is also characterized by a broad spectrum of antifungal activity.
Terbinafine does not affect the cytochrome P450 system, therefore it does not affect the metabolism of hormones and other drugs.
Pharmacodynamics and pharmacokinetics
When taking Lamisil tablets inside terbinafine is absorbed relatively quickly: the level of absolute bioavailability of the substance associated with the "first pass" effect is about 50%. After an oral dose of 250 mg, the maximum plasma concentration of terbinafine is observed after 90 minutes. In this case, the level of the substance in the blood increases with regular intake of the drug.
The bioavailability of terbinafine depends on food intake to an insignificant extent, therefore, dose adjustment when taken with meals is not required.
Terbinafine binds to plasma proteins by 99%. It quickly penetrates into the dermal layer of the skin and concentrates in the lipophilic stratum corneum. There is a high concentration of terbinafine in areas of the skin with a large number of sebaceous glands, hair follicles, hair. The active component of the drug is present in the nail plates in the first weeks after the start of therapy.
Terbinafine is rapidly metabolized to form metabolites that do not demonstrate antifungal activity and are excreted mainly through the kidneys.
With external application of a cream or spray Lamisil, the absorption of terbinafine is less than 5%. There is a slight systemic effect of the drug.
Indications for use
The use of all forms of the drug is indicated for the treatment and prevention of skin diseases caused by fungal infections:
- Dermatomycosis of smooth skin of the body (tinea corporis) caused by dermatophytes of the Trichophyton type, including T. rubrum, T. verrucosum, T. mentagrophytes, T. violaceum, Epidermophyton floccosum, Microsporum canis;
- Mycosis of the feet (tinea pedis), peeling of the skin and itching, cracks, cornification (due to foot fungus);
- Tinea craris inguinal epidermophytosis;
- Yeast infections of the skin, mainly caused by fungi of the genus Candida (including Candida albicans), including diaper rash.
In addition, Lamisil is prescribed:
- Tablets: in the treatment of onychomycosis caused by dermatophyte fungi and mycosis of the scalp;
- Cream and spray: for the treatment of varicoloured lichen (Pityriasis versicolor) caused by dimorphic fungi (Malassezia furfur).
Contraindications
The use of all forms of Lamisil is contraindicated in case of hypersensitivity to terbinafine or to the auxiliary components of the drug.
Do not take pills:
- The period of pregnancy (except in special cases when the expected clinical effect exceeds the potential threat to the fetus);
- Breastfeeding period.
With caution Lamisil should be prescribed:
- Tablets: in case of impaired renal function (creatinine clearance less than 50 ml / min), chronic or active liver diseases;
- Cream and spray: for liver and / or kidney failure, chronic alcoholism, tumors, inhibition of bone marrow hematopoiesis, metabolic diseases, occlusive pathologies of the limb vessels, during pregnancy.
Age restrictions of use:
- Tablets: children under 2 years old;
- Cream: children under 12;
- Spray: children under 2 years old.
Instructions for the use of Lamisil: method and dosage
Pills
It is taken orally 1 time per day. The dose and duration of therapy is prescribed by the doctor based on clinical indications and the patient's condition. Recommended daily dosage: for adult patients - 1 tablet; for children weighing: up to 20 kg - ¼ tablet each, from 20 to 40 kg - ½ tablet each, over 40 kg - 1 tablet each. The drug is well tolerated in children. The recommended duration of taking the tablets: mycosis of the scalp (more often observed in children) - 4 weeks; dermatomycosis of the feet (plantar, interdigital, or sock-like) - from 2 to 6 weeks; dermatomycosis of the trunk and legs, candidiasis of the skin - 2-4 weeks; onychomycosis - from 6 to 12 weeks (on the hands - 6 weeks, on the feet - 12 weeks) or the period of regrowth of a new healthy nail (with a reduced rate of nail growth, longer treatment may be required). In the absence of concomitant violations of liver and / or kidney function, elderly patients do not need dose adjustment;
Cream for external use
It should be applied in a thin layer to the previously cleaned and dried affected area of the body and rubbed into the skin with light movements, capturing the adjacent areas. In the treatment of diaper rash in the interdigital spaces, under the mammary glands, between the buttocks and in the groin area, the use of gauze dressings is indicated, especially when applying the cream at night. The frequency of procedures and the period of treatment depends on the clinical indications: ringworm of the trunk, legs, feet - 1 time per day for 1 week, with ringworm of the feet, aggravated by cornification, cracks, peeling and itching of the skin - 1-2 times a day for 2 weeks; candidiasis of the skin - 1-2 times a day for 1-2 weeks; with multi-colored lichen - 1-2 times a day for 2 weeks. In the absence of signs of effect after 1-2 weeks of therapy, it is necessary to consult a doctor to verify the diagnosis;
Spray for external use
Apply by spraying on previously cleaned and dried affected and adjacent areas of the body until the stage of thorough hydration of the skin. The period of treatment and the frequency of sprays: for dermatomycosis of the feet, legs and trunk - 1 week, 1 time per day; with multi-colored lichen - 1 week, 2 times a day; with epidermophytosis groin, diaper rash - 1 week, 1 time per day.
Side effects
Despite the fact that Lamisil tablets are generally well tolerated by patients, their use can cause side effects:
- Digestive system: very often - nausea, loss of appetite, feeling of fullness in the stomach, indigestion, mild abdominal pain, diarrhea;
- Hematopoietic system: very rarely - neutropenia, agranulocytosis, pancytopenia, thrombocytopenia;
- Hepatobiliary system: rarely - hepatobiliary dysfunction (more often of a cholestatic nature), including cases of severe hepatic failure (including fatal or requiring liver transplantation), usually in patients with serious concomitant systemic pathologies;
- Immune system: very rarely - anaphylactoid reactions (including angioedema), lupus erythematosus (cutaneous and systemic);
- Musculoskeletal system: very often - myalgia, arthralgia;
- Nervous system: often - headache; sometimes - a violation or loss of taste (after the cancellation of treatment, the restoration of taste buds occurs in a few weeks); very rarely - paresthesia, dizziness, hypesthesia; in some cases - weight loss against the background of a decrease in food intake;
- From the subcutaneous tissue and skin: very often - minor skin reactions in the form of rash and urticaria; very rarely - toxic epidermal necrolysis, Stevens-Johnson syndrome and other severe skin reactions, exacerbation of psoriasis or psoriasis-like skin rashes; very rarely - hair loss;
- Others: very rarely - feeling tired.
According to the instructions, Lamisil in the form of a cream and spray can cause the following undesirable actions:
- Local reactions: burning or itching sensation, redness;
- Others: the development of allergic reactions.
Overdose
When taken orally in large doses (5 g or more), manifestations of such symptoms of Lamisil overdose as headache, dizziness, pain in the epigastric region, nausea are possible. In this case, it is necessary to take activated charcoal, rinse the stomach and prescribe symptomatic treatment.
special instructions
Terbinafine inhibits the metabolism of tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers, monoamine oxidase type B inhibitors, class 1C antiarrhythmics, which are mediated by the CYP2D6 enzyme. If the simultaneous administration of these drugs with Lamisil tablets has a small range of therapeutic concentrations, it should be accompanied by constant monitoring.
If the use of tablets causes qualitative or quantitative changes in the blood cells, it is necessary to determine the cause of the violations and reduce the dose of the drug, if necessary, consider canceling it.
With the progression of a skin rash while taking Lamisil tablets, therapy should be discontinued.
If the action of the pills causes dizziness, then during the period of taking them, patients are advised to temporarily refuse to drive vehicles and mechanisms.
The use of cream and spray reduces the severity of clinical manifestations after several days of treatment. Premature discontinuation and irregular use may cause recurrence of the infection.
Lamisil cream and spray are intended exclusively for external use. Do not allow them to come into contact with the eyes, as this may cause irritation. In case of accidental contact with the drug, the eyes should be immediately rinsed with running water, and if persistent irritation develops, consult a specialist.
If allergic reactions develop against the background of the use of a cream or spray, the drugs must be canceled.
If there is no therapeutic effect after 1 week of using the spray, it is necessary to clarify the diagnosis.
Since the presence of alcohol in the spray can cause irritation, care must be taken when spraying it onto the affected skin.
Do not allow the spray to enter the respiratory tract.
When treating large areas of fungal infections of the body, tubes of 30 g of cream or bottles of spray with a volume of 30 ml should be used.
The spray does not affect the patient's ability to drive vehicles and mechanisms.
Application in children
Lamisil tablets are prescribed for children over 2 years old. Cream and spray should not be used to treat children under 12 years of age.
Pregnancy and lactation
The effectiveness and safety of using Lamisil during pregnancy have not been confirmed by the results of relevant clinical studies, therefore, it is not prescribed during this period. The use of the drug is possible only if the potential benefits of therapy to the mother outweigh the possible risks to the fetus. During treatment, breastfeeding should be discontinued.
Drug interactions
Cimetidine can increase the concentration of terbinafine in blood plasma or enhance its effect.
Rifampicin is able to weaken the effect of terbinafine or reduce its plasma content due to a possible increase in terbinafine clearance up to 100%.
If it is necessary to simultaneously take metabolism inducers and inhibitors of cytochrome P450 with Lamisil tablets, you should consider adjusting the dose of terbinafine.
The effect of terbinafine should be taken into account while taking Lamisil tablets with drugs, the metabolism of which is realized with the participation of the cytochrome P450 system. These drugs include terfenadine, triazolam, tolbutamide, oral contraceptives. The exception is drugs metabolized with the participation of CYP2D6.
When combined with digoxin or antipyrine, tablets do not affect their clearance, and with caffeine, they enhance its effect.
If the simultaneous use of tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers, monoamine oxidase B type inhibitors and class 1A, 1B and 1C antiarrhythmic drugs is limited to a small range of their therapeutic concentration, then terbinafine can suppress their metabolism.
Lamisil reduces the clearance of desipramine, weakens the effect of cyclosporine, reducing its concentration in blood plasma.
The interaction of the cream and spray with other drugs is unknown.
Analogs
Analogues of Lamisil are: Lamisil Uno, Thermikon, Terbinafin, Terbinafin-MFF, Terbifin, Terbizil, Exifin, Terbiks, Binafin, Fungoterbin, Exeter.
Terms and conditions of storage
Keep out of reach of children at temperatures up to 30 ° C.
Protect tablets from direct sunlight.
Spray - do not freeze.
Shelf life: tablets and cream - 5 years, spray - 3 years.
Terms of dispensing from pharmacies
The cream and spray are available over the counter.
The tablets are available with a prescription.
Reviews about Lamisil
Reviews about Lamisil are mostly positive. Despite the relatively high cost of the drug, it is considered an effective treatment for nail fungus. Within a few days after the start of treatment, an improvement in the condition of the patients is noted. The most rapid achievement of the desired result is possible with a combination of pills with the use of a cream or Lamisil spray. However, in the treatment of nail fungus and other fungal diseases, the use of only local forms of the drug is also successful.
There are also a few negative reviews about the lack of effectiveness of the drug.
Lamisil price
The price of Lamisil in the form of tablets is on average 2,100-2,300 rubles (14 pcs per pack). The cost of Lamisil spray varies from 550 to 700 rubles (for a 15 ml bottle) and from 750 to 850 rubles (for a 30 ml bottle). Lamisil cream can be purchased for about 500-600 rubles (for a tube of 15 g) and 800-900 rubles (for a tube of 30 g).
Lamisil: prices in online pharmacies
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Drug name Price Pharmacy |
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Lamisil 1% spray for external use 15 ml 1 pc. RUB 350 Buy |
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Lamisil 1% cream for external use 15 g 1 pc. 469 r Buy |
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Lamisil Dermgel 1% gel for external use 15 g 1 pc. 480 RUB Buy |
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Lamisil Lamisil Cream for the treatment of foot fungus, cream 1%, 15g. 483 r Buy |
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Lamisil Lamisil Dermgel for the treatment of foot fungus, gel 1%, 15g. 491 r Buy |
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Lamisil 1% spray for external use 30 ml 1 pc. RUB 685 Buy |
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Lamisil Lamisil Spray for the treatment of foot fungus, spray 1%, 30ml. 698 r Buy |
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Lamisil 1% cream for external use 30 g 1 pc. 756 r Buy |
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Lamisil Uno 1% solution for external use film-forming 4 g 1 pc. 761 RUB Buy |
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Reviews Lamisil Uno 761 RUB Buy |
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Lamisil Lamisil Cream for the treatment of foot fungus, cream 1%, 30g. 777 RUB Buy |
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Lamisil Lamisil UNO for the treatment of foot fungus, solution 1%, 4g. 783 r Buy |
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Lamisil 250 mg tablets 14 pcs. RUB 1708 Buy |
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Lamisil tablets 250mg 14 pcs. 2014 RUB Buy |
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Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
