Terbinafine

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: May 30, 2023

Warnings

Terbinafine Risks, Warnings, and Complications

Terbinafine can cause or worsen health problems in some people. Talk to your doctor or pharmacist about other treatments for fungal infections if you are at an increased risk of adverse reactions or complications from terbinafine. Some of the risks of taking terbinafine include:

LIVER INJURY: Very rarely, terbinafine can cause severe liver damage and even liver failure requiring liver transplantation. The risk of liver problems is higher if you have pre-existing liver disease. Your healthcare provider will order blood tests to check your liver function before and during terbinafine treatment. Tell your doctor without delay if you develop upper abdominal pain, nausea, vomiting, yellowing of the skin or eyes, dark urine, or pale stools.
SMELL AND TASTE DISTURBANCES: Terbinafine can cause changes in taste and smell. These changes may be temporary, but they can also be a persistent loss of taste and smell. Tell your doctor if you notice any smell or taste disturbances. Your doctor may ask you to discontinue terbinafine.
DEPRESSIVE SYMPTOMS: Terbinafine can lead to mood changes and depression in some people. Tell your doctor if you notice any unusual changes in mood, sleep disturbances, or depressive symptoms while on this medicine.
LEUCOPENIA: Rarely, terbinafine can cause a drop in the number of white blood cells in the body, which are needed to fight off infections. If this occurs, you can fall sick easily and take a longer time to recover from infections, which can be life-threatening. People with a weakened immune system and those who take terbinafine for more than 6 weeks are at a higher risk of this complication. Your doctor may order regular blood tests to check white blood cells during treatment with terbinafine. If your levels drop too low, you may need to discontinue terbinafine. Call your doctor without delay if you develop flu-like symptoms (fever, chills, sore throat).
SERIOUS SKIN REACTIONS: Very rarely, serious and potentially life-threatening skin reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported with terbinafine use. Seek immediate medical attention if you develop a severe skin rash with painful blisters all over your body, fever, flu-like symptoms, or mouth sores.
FLARE OF SYSTEMIC LUPUS ERYTHEMATOSUS: Rarely, terbinafine can cause a flare-up of systemic lupus erythematosus in people who have this condition. If this happens, you may need to stop terbinafine treatment. Tell your healthcare provider if you have lupus before starting terbinafine.

Precautions Before Starting Terbinafine

Tell your doctor if you have ever had an allergic reaction to terbinafine, any of the active or inactive ingredients in oral terbinafine formulations, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible interactions between your medications.

Give your doctor a complete medical history. Terbinafine may not be right for people with certain health conditions, such as liver disease, kidney disease, HIV/AIDS, a weakened immune system, or lupus.

Tell your healthcare professional if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

Precautions During Use of Terbinafine

Keep all your healthcare appointments during terbinafine treatment. Your doctor may want to order laboratory tests to keep an eye on liver function and blood cell counts.

Terbinafine can increase the sensitivity of your skin to sunlight. Avoid unnecessary sun exposure and use of tanning beds. Wear protective clothing and sunscreen to protect your skin.

Tell your doctor if you become pregnant while taking terbinafine. Do not nurse an infant with breast milk while on this medicine.

Tell all your healthcare providers you are on terbinafine, especially before any procedure, including dental procedures

Terbinafine Drug Interactions

Certain other drugs can affect how terbinafine works. Possible interactions with other medicines can increase the risk of severe adverse effects. The following medications can have interactions with terbinafine:

Medications used to treat heart rhythm abnormalities, such as amiodarone (Cordarone, Nexterone, Pacerone), flecainide, and propafenone (Rythmol)
Beta blockers such as labetalol (Trandate), atenolol (Tenormin), metoprolol (Lopressor, Toprol XL), propranolol (Hemangeol, Inderal LA, Innopran XL), and nadolol (Corgard)
Cough suppressants such as dextromethorphan (Delsym, in Mucinex DM, Promethazine DM, others)
Caffeine (in Excedrin, Fioricet, Fiorinal, others)
H2 blockers for stomach acidity, such as cimetidine (Tagamet)
Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune)
Antifungal medications such as fluconazole (Diflucan) and ketoconazole (Nizoral)
Monoamine oxidase type B (MAO-B) inhibitors such as selegiline (Eldepryl, Emsam, Zelapar) and rasagiline (Azilect)
Anti-tubercular drugs such as rifampin (Rifater, Rimactane, Rifadin, in Rifamate)
Antidepressants such as selective serotonin reuptake inhibitors (SSRIs), for example, fluoxetine (Prozac), citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), sertraline (Zoloft) and paroxetine (Paxil)
Tricyclic antidepressants (TCAs) such as desipramine (Norpramin), amoxapine, amitriptyline, protriptyline (Vivactil), clomipramine (Anafranil), imipramine (Tofranil), doxepin (Silenor), nortriptyline (Pamelor), and trimipramine (Surmontil)

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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