Combination therapy consisting of week pulses of oral terbinafine plus topical application of terbinafine cream in the treatment of onychomycosis

Sanmano, B; Hiruma, Masataro; Mizoguchi, Masayuki; Ogawa, Hideoki

doi:10.1080/09546630410035329

Cited by 8 publications

(9 citation statements)

References 26 publications

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“…When terbinafine is given orally at a dosage of 250 mg day −1 for 6–12 weeks, it persists in the nail plate for an additional 30–36 weeks at concentrations above the minimum inhibitory concentrations of several dermatophyte species 3 . Researchers have hypothesized that pulse therapy with terbinafine should be effective for treatment of onychomycosis 4–9 …”

Section: Discussionmentioning

confidence: 99%

“…Sanmmano et al. [8] reported that combination of pulse therapy with terbinafine 250 mg and daily application of topical terbinafine cream achieved good results and provided good patient compliance.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, in Japan, dermatophyte onychomycosis is usually treated with terbinafine given daily at a dose of 125 mg day −1 for 5 to 6 months. The pharmacokinetic properties of terbinafine are similar to those of itraconazole, which is widely administered using pulse therapy, and a few reports have described terbinafine pulse therapy for the treatment of dermatophyte onychomycosis 4–9 . Recently, we reported a pilot study showing terbinafine pulse therapy to be effective in treatment of dermatophyte onychomycosis 10 …”

Section: Introductionmentioning

confidence: 90%

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Treatment of dermatophyte onychomycosis with three pulses of terbinafine (500 mg day⁻¹ for a week)

Takahata

Hiruma

Shiraki

et al. 2008

Mycoses

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We assessed the safety and efficacy of pulse therapy with terbinafine tablets in 55 patients with dermatophytic onychomycosis. One pulse consisted of oral terbinafine tablets (500 mg day(-1)) given for 1 week usually followed by a 3-week interval. This regimen was repeated twice. Topical 1% terbinafine cream was applied daily. Efficacy was assessed based on both clinical and mycological examinations 1 year after treatment initiation. We observed a complete cure in 41 patients (74.5%), marked improved in three patients (5.6%), slight improvement in three patients (5.6%) and drop out in six patients (10.7%). Two patients (3.6%) discontinued terbinafine because of gastrointestinal disturbance (one patient) and drug-induced eruption (one patient). No patient had abnormal laboratory findings, including liver function tests. In summary, a regimen of three pulses of terbinafine therapy given daily for 1 week in combination with topical application of terbinafine cream appears to be safe and effective in treating dermatophytic onychomycosis and offers advantages in convenience and cost-effectiveness compared with continuous dosing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

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Treatment of dermatophyte onychomycosis with three pulses of terbinafine (500 mg day⁻¹ for a week)

Takahata

Hiruma

Shiraki

et al. 2008

Mycoses

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“…From these facts, it would be interesting to know whether or not pulse therapy with terbinafine is also effective. In this, some clinical trials have reported favorable results by intermittent dosing of terbinafine 4–8,12–14 …”

Section: Discussionmentioning

confidence: 99%

“…Sanmmano et al. reported that combination of pulse therapy with terbinafine 250 mg and topical terbinafine cream achieved good results and provided good patient compliance 7 . Zaias et al.…”

Section: Discussionmentioning

confidence: 99%

Combination of pulse therapy with terbinafine tablets and topical terbinafine cream for the treatment of dermatophyte onychomycosis: A pilot study

Nakano

Hiruma

Shiraki

et al. 2006

The Journal of Dermatology

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We performed a pilot study to assess the safety and efficacy of pulse therapy with terbinafine tablets in 66 patients with dermatophyte onychomycosis. One pulse consisted of oral terbinafine tablets (500 mg/day) given for 1 week followed by a 3-week interval. Topical 1% terbinafine cream was applied daily. The number of pulses was determined by the extent of improvement in the affected nails and by the patient's requests, up to a maximum of six pulses. Efficacy was assessed based on both clinical and mycological examinations 1 year after treatment initiation. We observed a complete cure in 51 patients (77.3%), marked improvement in five patients (7.6%), improvement in five patients (7.6%) and slight improvement in one patient (1.5%). Four patients (6.0%) showed no change. In the patients who were completely cured, the average number of pulses used was 3.7 +/- 1.4 pulses and the treatment duration was 3.3 +/- 1.6 months. Nine patients experienced adverse effects, consisting of gastrointestinal disturbance (eight patients) and drug-induced eruption (one patient). There were no abnormal findings in the laboratory tests, including liver function tests. In summary, terbinafine pulse therapy in combination with topical application of terbinafine cream appeared safe and effective in this pilot study.

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The Safety of Oral Antifungal Treatments for Superficial Dermatophytosis and Onychomycosis: A Meta-analysis

Chang

Young‐Xu²,

Kurth

et al. 2007

The American Journal of Medicine

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Combination therapy consisting of week pulses of oral terbinafine plus topical application of terbinafine cream in the treatment of onychomycosis

Abstract: Favorable treatment outcome was gained from this terbinafine 1-week pulse regimen and also better compliance compared with a standard daily regimen.

Cited by 8 publications

References 26 publications

Treatment of dermatophyte onychomycosis with three pulses of terbinafine (500 mg day⁻¹ for a week)

Treatment of dermatophyte onychomycosis with three pulses of terbinafine (500 mg day⁻¹ for a week)

Combination of pulse therapy with terbinafine tablets and topical terbinafine cream for the treatment of dermatophyte onychomycosis: A pilot study

The Safety of Oral Antifungal Treatments for Superficial Dermatophytosis and Onychomycosis: A Meta-analysis

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Combination therapy consisting of week pulses of oral terbinafine plus topical application of terbinafine cream in the treatment of onychomycosis

Abstract: Favorable treatment outcome was gained from this terbinafine 1-week pulse regimen and also better compliance compared with a standard daily regimen.

Cited by 8 publications

References 26 publications

Treatment of dermatophyte onychomycosis with three pulses of terbinafine (500 mg day−1 for a week)

Treatment of dermatophyte onychomycosis with three pulses of terbinafine (500 mg day−1 for a week)

Combination of pulse therapy with terbinafine tablets and topical terbinafine cream for the treatment of dermatophyte onychomycosis: A pilot study

The Safety of Oral Antifungal Treatments for Superficial Dermatophytosis and Onychomycosis: A Meta-analysis

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Treatment of dermatophyte onychomycosis with three pulses of terbinafine (500 mg day⁻¹ for a week)

Treatment of dermatophyte onychomycosis with three pulses of terbinafine (500 mg day⁻¹ for a week)