Terbinafine Hepatotoxicity: Case Report and Review of the Literature

Fernandes, N; Geller, Stephen A.; Fong, Tse‐Ling

doi:10.1111/j.1572-0241.1998.00459.x

Cited by 47 publications

(14 citation statements)

References 7 publications

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“…While the majority of cases resolve following discontinuation of terbinafi ne, reports are available detailing patients that have progressed to liver transplantation and death. 189,190 Notably, hepatic fi ndings are not restricted to adults. An FDA review of the recently marketed terbinafine oral granule identifi ed two cases, among 1042 children treated, of elevated transaminases leading to discontinuation of the drug.…”

Section: Adverse Effectsmentioning

confidence: 99%

Update on terbinafine with a focus on dermatophytoses

Newland¹,

Abdel‐Rahman

2009

CCID

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Since terbinafi ne was introduced on the world market 17 years ago, it has become the leading antifungal for the treatment of superfi cial fungal infections, aided by unique pharmacologic and microbiologic profi les. This article reviews mode of action, antimycotic spectrum and disposition profi le of terbinafi ne. It examines the data, accumulated over 15 years, on the comparative effi cacy of terbinafi ne (vs griseofulvin, itraconazole, fl uconazole) in the management of the infections for which it is primarily indicated (eg, dermatophytoses) and provides a brief discussion on its use for the treatment of non-dermatophyte infections. Finally, the available data on the newest topical and systemic formulations are introduced.

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Section: Adverse Effectsmentioning

confidence: 99%

Update on terbinafine with a focus on dermatophytoses

Newland¹,

Abdel‐Rahman

2009

CCID

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“…Very recently, a systematic review and meta-analysis documented an overall incidence of 3.6%-4.2%, which may be considered as common [31] . Data on other antifungals such as terbinafine are more scant and mostly based on individual case reports [32][33][34] . The latest population-based study in Taiwanese concluded that oral antifungal agents are associated with a low incidence if DILI, which may be fatal (especially in the elderly) and increased for longer treatment [35] .…”

Section: Data Selection and Analysismentioning

confidence: 99%

Assessing liver injury associated with antimycotics: Concise literature review and clues from data mining of the FAERS database

Raschi¹,

Poluzzi²,

Koci³

et al. 2014

WJH

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AIM: To inform clinicians on the level of hepatotoxic risk among antimycotics in the post-marketing setting, following the marketing suspension of oral ketoconazole for drug-induced liver injury (DILI). METHODS:The publicly available international FAERS database (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011) was used to extract DILI cases (including acute liver failure events), where antimycotics with systemic use or potential systemic absorption were reported as suspect or interacting agents. The reporting pattern was analyzed by calculating the reporting odds ratio and corresponding 95%CI, a measure of disproportionality, with time-trend analysis where appropriate. RESULTS:From 1687284 reports submitted over the 8-year period, 68115 regarded liver injury. Of these, 2.9% are related to antimycotics (1964 cases, of which 112 of acute liver failure). Eleven systemic antimycotics (including ketoconazole and the newer triazole derivatives voriconazole and posaconazole) and terbinafine (used systemically to treat onychomicosis) generated a significant disproportionality, indicating a post-marketing signal of risk. CONCLUSION:Virtually all antimycotics with systemic action or absorption are commonly reported in clinically significant cases of DILI. Clinicians must be aware of this aspect and monitor patients in case switch is considered, especially in critical poly-treated patients under chronic treatment.

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“…Patient ages ranged from ‘young’1 to 75 years old 2. The typical symptoms of terbinafine-induced hepatotoxicity include marked and progressive pruritus, jaundice, malaise and anorexia 2 4 5. Typically, symptom onset is from weeks 3–6 of therapy but may peak after cessation of terbinafine 1 2 5…”

Section: Discussionmentioning

confidence: 99%

A curious case of cholestasis: oral terbinafine associated with cholestatic jaundice and subsequent erythema nodosum

et al. 2014

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Terbinafine is a commonly prescribed antifungal agent used in the treatment of trichophytic onychomycosis and chronic cutaneous mycosis that are resistant to other treatments. This case report highlights a rarely documented but important adverse hepatic reaction that was caused by the use of oral terbinafine. A woman in her thirties presented with a 3-week history of jaundice, malaise, itching, nausea, decreased appetite, weight loss, dark orange urine and intermittent non-radiating epigastric pain. She had recently finished a 3-week course of oral terbinafine for a fungal nail infection. Liver biopsy findings were consistent with chronic active hepatitis secondary to a drug reaction. A few days after initial presentation, the patient developed erythema nodosum. Delayed development of erythema nodosum secondary to terbinafine could not be excluded.

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Terbinafine Hepatotoxicity: Case Report and Review of the Literature

Cited by 47 publications

References 7 publications

Update on terbinafine with a focus on dermatophytoses

Update on terbinafine with a focus on dermatophytoses

Assessing liver injury associated with antimycotics: Concise literature review and clues from data mining of the FAERS database

A curious case of cholestasis: oral terbinafine associated with cholestatic jaundice and subsequent erythema nodosum

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