Terbinafine tablets

[Z064life]

Hi All,

So I have a fungal nail infection. The treatment of choice seems to be lamisil (contains terbinafine) but this is known to cause liver damage of varying degrees so I am quite reluctant to take this.

Has anyone taken this and what was the experience?


Thanks

[mikial]

I was prescribed Terbinafine for toenail fungus circa 2009 , I had five infected nails since my early twenties ( athletes foot spoor) . I got to 61 and decided to do something about it .
It's a very slow process but effective , as I remember six months is the recommended limit of time before your doctor checks your liver. I was given no reminders and so kept on taking the prescribed dose. If memory serves ( doubtful) I started to feel distinctly poorly after eight months . Went for a check up and was told to stop taking the meds immediately, liver enzymes were not up to scratch . Four of my nails were by now normal , just the stubborn one on the big toe , that's the reason I continued with the meds.
I remember thinking if that's the way you feel when your liver is on the way out then I'm on the wagon ! I stopped drinking alcohol for three years, lapsing only when I moved overseas.

If you manage your dosage correctly and heed your doctor there should be no problem, wouldn't hurt to reduce or stop drinking for the duration of the prescribed meds.
I recovered fully and have a beautiful set of toenails....out here flip flops are essential footwear and I'm very aware of some of the expats here with truly dreadful looking feet.
Rambled on a bit but I'm allowed a bit of leeway , ' cos I'm an old geezer now.

[Armitage.Shanks]

Been on Terbinafine for around 12 months and probably on the last set of tablets to get rid of a nail infection that I shouldn't have left for so long. Not helped by the first GP I saw who I don't think wanted to spend the practice budget on NHS lab tests of nail cuttings/treatment and told me to live with it! It didn't really cause a problem but just hardening/yellowing of one toe nail that then appeared to start to spread to others on the same foot.

I had to have a blood test first for liver function before they would prescribe it and whilst I was offered the cream its not believed to be very effective. Bloods came back OK and I've not been given a repeat prescription unless I've had a blood test first - approx every 3 months. Every time it's come back fine and I've had no side effects/issues.

[JagBox]

Took it for four months for 4 nails that were infected. Blood test to check the liver and then repeat prescription. After 4 months I had a clean nail growing from the nail bed so at that point you can stop. The infected part of the nail was all eventually clipped off as they grew out.

Worth the effort.......

[Armitage.Shanks]

JagBox said:

Took it for four months for 4 nails that were infected. Blood test to check the liver and then repeat prescription. After 4 months I had a clean nail growing from the nail bed so at that point you can stop. The infected part of the nail was all eventually clipped off as they grew out.

Worth the effort.......

Interesting as my GP wants to see all the infected nail gone with new growth.............I'm nearly there!

[Z064life]

Hi Guys,

mikial - so how did the remaining nail get sorted out?

I see my a dermatologist next week and will discuss this (have a wider condition where this plays a minor role). I will be discussing this in more detail then and a GP appointment on 1st November to discuss this too.

So did any of you consider nail avulsion? Or was it not mentioned? Or explicitly not recommended?

My healthcare professionals have all said these tablets can damage the liver, so no denying that, but there's a degree of sensationalism on the internet in that they've been attributed to liver transplants/death, hence the anxiety.

If they do damage the liver, that can be reversed as the liver can repair itself?
And if they harm the liver before the nails are remedied then what is the next solution?

[mikial]

The remaining nail on the big toe was virtually normal and self healed.
My liver also recovered and was back to normal fairly quickly with no ill effects, I'm drinking San Migs and wine plus the odd gin and tonic ( not all at once) and eat healthily.
My problems now ( seeing as you asked ) are tinnitus , vertigo ( caused by a double fractured skull, no helmet , hit a dog on the Ninja ) .
As I said previously, I don't see a problem taking terbinafine , it works fine.
I tried all the quack oilments before I went to my GP, I was on naproxen for gout too.
My cup runneth over !

[mikial]

I had to google nail avulsion , felt queasy looking at the images . It not something I would have considered when I decided to seek medical help to remedy the problem.
I underwent a medical examination, blood tests and liver function before my GP prescribed terbinafine. It was entirely my fault the problem arose.
If you stick to the recommend dosage , what could possibly go wrong ?

[jq74]

did you drink alcohol at all while taking Terbinafine? I have just started a treatment and anticipate being on them for a while so as to clear a fungal toe nail infection.. ok to have the odd drink or advisable to quit altogether? thanks for input.

[mikial]

I carried on drinking , Adnams, or London Pride if was available but mainly white wine .
As commented previously it's worth the effort.

[knk]

I would recommend pulse treatment with itraconazole, 200mg bd for 7 days, 21 day break then repeat. Usually needs 3 to 6 pulses.
You need LFTs monitoring.

Topical treatment with loceryl lacquer can be effective for mild cases, as can tea tree oil.