27.10.2021

Terbinafine or Fluconazole, which is more effective

Both drugs are aimed at combating fungal infections. They are applied systemically. They have a number of side effects. Available in the form of tablets and other forms. Before use, it is necessary to examine the characteristics of each.

Definitely it is impossible to say, because both are good, each in its own direction. Efficiency depends on the type of pathology.

For example, Terbinafine is better for treating onychomycosis, especially children under 4 years old, and Fluconazole will be more effective for treating genital candidiasis or cryptococcosis.

In some cases, the combined use of these drugs will be rational for the treatment of onychomycosis. Often, the use of Terbinafine ointment externally and capsules / tablets of Fluconazole orally leads to better results, while the healing time is shortened.

It is very good when the medication is selected by the attending physician, after examination, certain tests, anamnesis of concomitant diseases.

Pathogenic fungi parasitizing in the human body cause infectious diseases called mycoses. Although they do not lead to complications, they cause discomfort and worsen the quality of life. Alternative methods of treatment are not always effective, and more and more antifungal agents appear. For example, Terbinafine or Fluconazole are popular drugs. To make a choice, it is necessary to compare the action, composition, indications of each.

Terbinafine

Antifungal agent used systemically. It is produced in the form of ointment (15 g) and tablets (250 mg), spray, solution. The main active ingredient is terbinafine hydrochloride. In combination with additional substances, including lactose, cellulose, it affects fungal infections of the skin, nail plate, and hair caused by dermatophytes.

Terbinafine

The selected composition destroys the cell membrane of the fungal cell. As a result of specific inhibition of squalene oxidase, ergosterol production ceases, metabolic processes that have a detrimental effect on fungal cells are switched on.

The fungicidal effect extends to fungi:

  • Moldy.
  • Dimorphic.
  • Dermatophytes.
  • Yeast-like (some species).

Fungicidal action is carried out due to the accumulation of the main substance in the skin, hair, nails.

Ointment Tablets Spray solution
Adults

Adults with kidney, liver disease

On a treated, dried surface thinly, rubbing a little 1-2 times / day; course up to 4 weeks 250 mg per day in one or two doses; 1-2 weeks course

125 mg 1 time / day

On a clean, dry surface 1-2 times
Children’s category of patients weighing ≤ 20 kg

Weight category ≥ 20-40 kg

62.5 mg / day

125 mg / day

Who is prescribed the drug and duration of treatment:

Disease Course of therapy
Dermatitis of the soles between the toes Up to 42 days
Dermatic damage to the body, legs (lower legs) Up to 28 days (1st week 1 time / day) spray or solution
Candidiasis of the skin Up to 28 days
Mycosis hair Up to 28 days

Usually the medicine is well tolerated. Adverse reactions are mild or moderate, rapidly passing.

Fluconazole

A synthetic triazole derivative against fungal infections, used systemically. The main part of the drug is flucanazole. Available in the form of tablets under the shell (100 mg), capsules (150 mg, 50 mg, 200 mg), 0.2% infusion solution (100 ml).

Fluconazole

The drug belongs to powerful inhibitors of fungal enzymes, the main role of which is the synthesis of mycotic ergosterol. Through this membrane, fungal cells lose their ergosterol and react to the effect of the drug.

The effect of the drug extends to:

  • Candida yeast (excluding C.krusel).
  • Endemic moldy mushrooms.
  • Streptococcus
  • Cryptococci.

The drug product is well absorbed, penetrating the body fluids: saliva, sputum, blood. Metabolism is negligible, about 11% is excreted by the urinary system. This process takes 30 hours. Due to this, with some lesions, a single use of the drug is sufficient. Sometimes it is prescribed once every 7 days. In patients with diseased kidneys, the elimination time increases to 98 hours, so the dosage requires adjustment.

Apply, depending on the dosage form, orally or intravenously by infusion. Indications and dosage:

Disease Dosage
Vaginal infections (candida white) Single use
Cryptococcal infections (meningitis) The first day – 400 mg; subsequent – 200-400 mg once a day; course up to 8 weeks
Prevention of cryptococcal meningitis 200 mg / day for a long time
Valley fever 200-400 mg / day; course up to 2 years
Lesions of the mucocutaneous tissue (invasive thrush) The first day – 800 mg, then 400 mg; 2 weeks course
Mycosis of the oral cavity The first day – 200-400 mg, then 100-200 mg; 3 weeks course
Esophagus thrush The first day – 200-400 mg; further 100-200 mg; month course
Chronic fungal lesions of the skin 50-100 mg / day; 4 weeks course
Fungal infections of the urinary system 200-400 mg / day; 3 weeks course
Chronic form of atrophic thrush 50 mg per day; 2 weeks course
Fungus stop 150 mg once a week; course up to 6 weeks
Infections of the stratum corneum of the epidermis (multicolored lichen) Up to 400 mg once a week; course 21 days
Onychomycosis 150 mg per week; course up to a year

In the treatment of children, the dose should not be more than 400 mg / essence.

Distinctive features

Terbinafine is an antifungal drug from the group of allylamines, and fluconazole is an azole.

The main action of the first is aimed at dermatophytes, therefore, it is prescribed primarily for the destruction of dermatomycoses. Fluconazole is more effective against candidiasis pathogens. Fluconazole has more contraindications:

Terbinafine Fluconazole
Hypersensitivity to one of the components of the drug Hypersensitivity to azole compounds
Simultaneous use (more than 400 mg / day) with terbinafine
The simultaneous use of drugs that extend the QT interval

Terbinafine is used in the treatment of children from 2 years old, and fluconazole is contraindicated until 4 years of age. Fluconazole has a wider range of indications, but has more side effects on the vital organs, including the liver.

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