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Mycofree is an allylamine antifungal drug used for different fungal infections:
Tablet (Oral): Treatment of onychomycosis (fungal infection of the nail) of the toenail or fingernail caused by dermatophytes (Tinea Unguium).
Granules (Oral): Treatment of Tinea Capitis (scalp ringworm).
Cream (Topical): Fungal skin infections including Tinea Corporis/Cruris/Pedis, cutaneous Candidiasis, and Pityriasis Versicolor.
1% Spray (Topical): Treatment of tinea infections of the skin and Pityriasis Versicolor.
Terbinafine is fungicidal and works by inhibiting the Squalene Epoxidase enzyme, which is involved in Ergosterol biosynthesis. This causes squalene to accumulate, increasing the fungal cell membrane's permeability and leading to cell death.
| Formulation | Condition | Dose | Duration |
|---|---|---|---|
Tablet (250 mg) | Fingernail Onychomycosis | 250 mg once daily | 6 weeks |
| Toenail Onychomycosis | 250 mg once daily | 12 weeks | |
Cream | Tinea Corporis/Cruris | Apply a thin layer once or twice daily | 1-2 weeks |
| Tinea Pedis | Apply a thin layer once or twice daily | 1 week | |
1% Spray | Tinea Pedis/Corporis/Cruris | Apply to wet area once a day | 1 week |
| Pityriasis Versicolor | Apply to wet area twice a day | 1 week |
Note: For oral treatment, the optimal clinical effect is seen months after cessation due to the time required for healthy nail growth.
Contraindications: Hypersensitivity to Terbinafine.
Liver Risk (Tablets): Rare cases of liver failure (some fatal or requiring transplant) have occurred. Discontinue treatment immediately if there is biochemical or clinical evidence of liver injury. Pretreatment serum transaminase ( and ) tests are advised for all patients. Not recommended for patients with chronic or active liver disease.
Skin Reactions (Tablets): Discontinue if a progressive skin rash (e.g., Stevens-Johnson Syndrome) occurs.
Topical: Cream is for external use only; avoid contact with the eyes.
Common side effects include gastrointestinal symptoms (diarrhea, dyspepsia, abdominal pain), rash, itching, and taste disturbances. Rare but serious side effects include hepatic injury, serious skin reactions, and severe neutropenia.
Terbinafine is an inhibitor of the 2D6 enzyme. Co-administration with drugs metabolized by 2D6 (such as tricyclic antidepressants, , and beta-blockers) requires careful monitoring and may necessitate a dose reduction of the co-administered drug.
Terbinafine tablets are generally not recommended during pregnancy or for nursing mothers, as it is present in breast milk.
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