Terbinafine Mechanism and Safety

Mechanism of Action and Contraindications

Terbinafine is an allylamine that acts on the fungal cell membrane and is fungicidal, according to the British Journal of Dermatology 1, 2
It inhibits squalene epoxidase, which is essential for ergosterol biosynthesis, resulting in both depletion of ergosterol and accumulation of squalene, as reported by the British Journal of Dermatology 2
Terbinafine is contraindicated in patients with active or chronic liver disease, as stated by the British Journal of Dermatology 3, 4
It is also contraindicated in patients with severe kidney disease, according to the British Journal of Dermatology 2
Additionally, terbinafine is contraindicated in patients with lupus erythematosus and porphyria, as noted by the British Journal of Dermatology 1, 5

Common side effects of oral terbinafine include gastrointestinal disturbances and dermatological events, such as nausea, diarrhea, taste disturbance, rash, pruritus, urticaria, and eczema, as reported by the British Journal of Dermatology 3, 4
Rare but serious adverse reactions include Stevens-Johnson syndrome, toxic epidermal necrolysis, and hepatic toxicity, particularly in patients with pre-existing liver disease, according to the British Journal of Dermatology 3, 4