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Open AccessArticle

A Week of Oral Terbinafine Pulse Regimen Every Three Months to Treat all Dermatophyte Onychomycosis

1
Santa Casa de Curitiba Hospital, Clinic of Diseases and Surgery of the Nail Apparatus, Department of Dermatology, Praça Rui Barbosa, 694, 80.010-030 Curitiba, Brazil
2
Hospital de Clínicas de Curitiba—Universidade Federal do Paraná (UFPR), Clinic of Dermatology, Rua General Carneiro, 181, 80.060-900 Curitiba, Brazil
3
Univerdidade Federal do Paraná (UFPR), Rua General Carneiro, 181, 80.060-900 Curitiba, Brazil
4
Hospital de Clínicas de Curitiba—Paraná Federal University (UFPR), Department of Public Health, Rua General Carneiro, 181, 80.060-900 Curitiba, Brazil
*
Author to whom correspondence should be addressed.
J. Fungi 2019, 5(3), 82; https://doi.org/10.3390/jof5030082
Received: 21 August 2019 / Revised: 1 September 2019 / Accepted: 3 September 2019 / Published: 4 September 2019
Terbinafine has proved to treat numerous fungal infections, including onychomycosis, successfully. Due to its liver metabolization and dependency on the cytochrome P450 enzyme complex, undesirable drug interaction are highly probable. Additionally to drug interactions, the treatment is long, rising the chances of the appearance of side effects and abandonment. Pharmacokinetic data suggest that terbinafine maintains a fungicidal effect within the nail up to 30 weeks after its last administration, which has aroused the possibility of a pulse therapy to reduce the side effects while treating onychomycosis. This study’s goal was to evaluate the effectiveness of three different oral terbinafine regimens in treating onychomycosis due to dermatophytes. Sixty-three patients with onychomycosis were sorted by convenience in three different groups. Patients from group 1 received the conventional terbinafine dose (250 mg per day for 3 months). Group 2 received a monthly week-long pulse-therapy dose (500 mg per day for 7 days a month, for 4 months) and group 3 received a 500 mg/day dose for 7 days every 3 months, totaling four treatments. There were no statistical differences regarding the effectiveness or side effects between the groups. Conclusion: A quarterly terbinafine pulse regimen can be a possible alternative for treating onychomycosis caused by dermatophytes. View Full-Text
Keywords: administration; allylamines/terbinafine; Arthrodermataceae/drug effects; drug compounding; humans; onychomycosis; oral; antifungal agents/administration; dosage/adverse effects/pharmacology administration; allylamines/terbinafine; Arthrodermataceae/drug effects; drug compounding; humans; onychomycosis; oral; antifungal agents/administration; dosage/adverse effects/pharmacology
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Sprenger, A.B.; Purim, K.S.M.; Sprenger, F.; Queiroz-Telles, F. A Week of Oral Terbinafine Pulse Regimen Every Three Months to Treat all Dermatophyte Onychomycosis. J. Fungi 2019, 5, 82.

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