How long should you take terbinafine for nail fungus. When to use terbinafine cream, gel, spray or tablets for different fungal infections. Dosage information and instructions on how to apply terbinafine correctly.

Understanding Terbinafine for Nail Fungus

Terbinafine is a popular antifungal medication used to treat a variety of fungal infections, including nail fungus. The treatment you use will depend on the location and severity of the infection. For large areas of skin or hairy regions, the spray formulation may be more effective. When purchasing terbinafine over-the-counter, it’s important to follow the instructions provided with your specific medication.

Dosage Guidelines for Terbinafine

Your doctor or pharmacist will provide guidance on the appropriate dosage and duration of terbinafine treatment, based on the type and severity of your fungal infection. For creams, gels, and sprays, the typical recommendation is to apply the product once or twice daily. Terbinafine solution, on the other hand, is a single-use treatment. Oral terbinafine tablets are typically taken once daily, with a course of 2 to 6 weeks, depending on the infection.

Applying Terbinafine Cream or Gel

When using terbinafine cream or gel, be sure to wash your hands before application. Wash and dry the affected area, and then apply a thin layer of the product to the infected skin. Gently rub it in, avoiding the mouth, lips, and eyes. Replace the cap and wash your hands again. If treating the area between your toes or in the groin, consider covering the area with a clean gauze dressing, especially at night.

Using Terbinafine Spray

The application process for terbinafine spray is similar to the cream or gel. Wash your hands, clean and dry the affected area, and then hold the spray bottle about 10 cm away from the skin and spray until the area is thoroughly wet. Avoid spraying near the mouth, lips, and eyes. Replace the cap and wash your hands.

Applying Terbinafine Solution (Lamisil Once)

Terbinafine solution, also known as Lamisil Once, is a single-use treatment for athlete’s foot. After showering or bathing, ensure your feet are completely dry, including between the toes. Apply the solution to both feet, even if only one appears infected. Do not rub or massage the solution, but rather let it dry for 1-2 minutes before replacing the cap and discarding the tube. Avoid washing or splashing your feet with water for 24 hours after application.

Taking Terbinafine Tablets

When taking terbinafine tablets, swallow the pill whole with a drink of water. You can take the tablets with or without food, but it’s best to take them at the same time each day. For fungal nail infections, you’ll typically need to take the tablets for several months, as these types of infections can take a long time to clear.

Treatment Duration and Considerations

The length of terbinafine treatment will depend on the type and severity of the fungal infection. Creams, gels, and sprays are usually used for 1-2 weeks, while oral tablets may be prescribed for 2-6 weeks for jock itch or athlete’s foot, or 6 weeks to 3 months (or longer) for fungal nail infections. It’s important to complete the full course of treatment, even if your symptoms improve, to prevent the infection from returning.

What if I Forget to Use Terbinafine?

If you forget to apply your terbinafine cream, gel, or spray, simply use it as soon as you remember and then continue with your regular routine. If you forget to take a terbinafine tablet, take it as soon as you remember, unless it’s almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule.

When Should I Seek Medical Advice?

Talk to your doctor if your symptoms do not improve within 2 weeks of using terbinafine cream, gel, or spray. Similarly, if you’re considering stopping your treatment for any reason, it’s best to consult your healthcare provider first to ensure the fungal infection doesn’t come back.

Proper use and completion of the terbinafine treatment course is crucial for effectively treating fungal infections and preventing recurrence. Always follow the instructions provided by your doctor or the medication’s packaging.

How and when to take or use terbinafine

The treatment you use will depend on where the infection is on your body and how severe it is.

For large areas of skin, or if the area is hairy, it’s best to use the spray.

If you buy terbinafine in a pharmacy or shop, follow the instructions that come with your medicine.

Dosage

Your doctor or pharmacist will tell you how much terbinafine to use and how long you need to use it for, depending on your infection.

If you’re using the cream, gel or spray, you’ll usually need to use it once or twice a day.

If you’re using the solution, you only use it once.

If you’re taking the tablets, the usual dose is 1 tablet, taken once a day. You’ll usually take the tablets for 2 to 6 weeks. This depends on the type of infection you have and how serious it is.

How to use terbinafine cream or gel

Put the cream or gel on the infected area once or twice a day for 1 to 2 weeks.

1. Wash your hands before using the cream or gel.
2. Wash and dry the infected skin where the cream or gel will go. If you’re treating your feet, it’s also important to wash and dry between your toes first.
3. Unscrew the cap.
4. Squeeze out a small amount of the cream or gel onto your finger (enough to put a thin layer on your skin).
5. Gently rub it into the infected areas. Avoid putting it near your mouth, lips and eyes.
6. Replace the cap.
7. Wash your hands.

If you’re using the cream or gel on the area between your toes, or on your bottom or groin, you can cover the skin with a clean strip of gauze afterwards. This type of light dressing is available to buy at pharmacies and is especially helpful to use at night.

How to use terbinafine spray

Put the spray on the infected area once or twice a day for 1 to 2 weeks.

1. Wash your hands before using the spray.
2. Wash and dry the infected skin before using the spray. If you’re treating your feet, it’s also important to wash and dry between your toes first.
3. Take the cap off and prepare the spray by pressing the top of the spray down once or twice.
4. Hold the bottle about 10cm away from the infected area and spray until your skin is thoroughly wet. Avoid getting it near your mouth, lips and eyes.
5. Replace the cap.
6. Wash your hands.

If you’re using the spray on the area between your toes, or on your bottom or groin, you can cover the skin with a clean strip of gauze afterwards. This type of light dressing is available to buy at pharmacies and is especially helpful to use at night.

How to use terbinafine solution (Lamisil Once)

The solution for athlete’s foot comes in a tube with a nozzle. It’s a single treatment that you only use once.

Use the solution on both feet even if one of them looks fine. If one foot looks less infected than the other, put the solution on the less infected foot first.

1. Use the solution after a shower or bath. Before using the solution, make sure your feet are dry, including between your toes.
2. Remove the cap.
3. Put the solution all over your toes, including between each toe, and on the sole, top and sides of your foot. This should use about half the tube. Finish treating this foot before treating the other.
4. Do not rub or massage the solution in.
5. Leave the solution to dry on your feet for 1 to 2 minutes.
6. Replace the cap and throw the tube away.
7. Wash your hands.
8. Put on your normal shoes and socks.

Do not wash or splash your feet with any water for 24 hours after using the solution.

After 24 hours, wash your feet with warm, soapy water in the bath or shower and gently pat them dry.

How to take terbinafine tablets

Swallow the tablet whole with a drink of water.

You can take terbinafine tablets with or without food. It’s best to take your tablets at the same time each day.

If you have a fungal nail infection, you’ll probably need to take the tablets for several months. These infections take a while to clear.

How long to take or use it for

If you’re using the cream, gel or spray, you’ll usually need to use it for 1 to 2 weeks. Talk to your doctor if your symptoms do not get better within 2 weeks.

If you’re taking the tablets, you’ll usually take them for:

• 2 to 4 weeks if you have jock itch
• 2 to 6 weeks if you have athlete’s foot
• 4 weeks if you have ringworm
• 6 weeks to 3 months (sometimes longer) if you have a fungal nail infection

It’s important to keep taking or using terbinafine until you finish the course, even if your symptoms get better. Follow the instructions from your doctor or on the leaflet that comes with the medicine.

If you stop using your terbinafine too soon, or if you do not use it as recommended, the fungal infection could come back.

Talk to your doctor if you’re thinking of stopping your treatment for any reason.

If you forget to take it or use it

If you forget to use your terbinafine cream, gel or spray, just use it as soon as you remember and then keep following your usual routine.

If you forget to take a terbinafine tablet, take it as soon as you remember, unless it’s nearly time for your next dose. In this case, just skip the missed dose and take your next one at the usual time. Then carry on until you have finished the course.

Do not take 2 doses to make up for a missed dose.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember your medicines.

If you take or use too much

If you use too much terbinafine cream, gel or spray or use it more often than you need to, it may make your skin irritated or red. If this happens, use less of the cream, gel or spray the next time.

Taking 1 or 2 extra terbinafine tablets is unlikely to harm you.

If you take more than this, you may get side effects including stomach pain, feeling or being sick, diarrhoea, headache or feeling dizzy.

Urgent advice: Contact 111 for advice now if:

• you take a lot of terbinafine tablets at the same time (4 or more) even if you have no side effects
• you take 2 or more terbinafine tablets and have side effects

Call 111 or go to 111.nhs.uk. Call 111 if you need advice for a child under the age of 5 years.

If you need to go to A&E do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the terbinafine packet, or the leaflet that came with your medicine, and any remaining medicine with you.

Common questions about terbinafine – NHS

How does terbinafine work?

Terbinafine is an antifungal medicine. It works by killing the fungus that is causing the infection.

It makes holes in the cell membrane of the fungus and the contents leak out. This kills the fungus and treats the infection.

When will I feel better?

It depends on the type of infection you have. Some will take longer to get better.

Terbinafine solution usually starts to work within a few days. Talk to your doctor if your symptoms do not get better within 1 week.

The cream, gel or spray usually starts to work within a few days. Talk to your doctor if your symptoms do not get better within 2 weeks.

Terbinafine tablets can take several weeks to work. If you have completed the course of tablets and still have symptoms, talk to your doctor.

Some fungal nail infections take 6 months or longer to get better. Nail infections often get better more quickly in younger people. Infections on the big toe often take longer to clear up than on other toes.

Are there any long-term side effects?

Terbinafine is usually used for a short time to clear an infection. Do not use it for longer than your pharmacist or doctor has recommended.

If you use it too often or for too long, the medicine may not work so well. This is because fungal infections can become resistant to terbinafine.

For some infections, such as fungal nail infections, you may need to take terbinafine tablets for up to 3 months (sometimes longer). It’s safe to take long term if your doctor tells you to.

What if it does not work?

If taking terbinafine is not working to clear an infection, your doctor may ask you to take it for longer or they may prescribe a different antifungal medicine.

If your symptoms get worse at any time, speak to your doctor.

Are there other medicines for fungal infections?

There are many different antifungal medicines. Some are available to buy from a pharmacy, and others are available on prescription.

They can come as creams, gels and sprays, pessaries (soft tablets you put into your vagina), tablets, capsules and liquid, or injections.

Your doctor or a pharmacist will be able to recommend the best treatment for you, based on your condition.

Other antifungal medicines include:

• clotrimazole
• fluconazole
• econazole
• itraconazole
• ketoconazole
• miconazole
• griseofulvin

Do I need to have blood tests if I’m taking terbinafine tablets?

If you take terbinafine tablets for a long time, your doctor may ask you to come back for a blood test. This is to check that your liver is working properly.

There is a small chance (less than 1 in 1,000) that terbinafine can affect your liver.

Will it affect my contraception?

Terbinafine is not likely to affect your contraception, including the combined pill or emergency contraception.

If taking terbinafine makes you sick (vomit) or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Find out what to do if you’re taking the pill and you’re being sick or have diarrhoea

There have been some reports of breakthrough bleeding, known as spotting, when people take terbinafine tablets and the combined pill together. It’s not known whether this is to do with the terbinafine. If you get any breakthrough bleeding while using oral contraception, speak to your doctor.

Can I donate blood if I’m using or taking terbinafine?

If you’re using terbinafine cream, gel, spray or solution, then it’s OK to donate blood.

But if you’re taking terbinafine tablets, it’s important to wait at least 7 days after completing the course of tablets before giving blood.

You can check if you’re able to give blood on the NHS Give Blood website.

Can I drive or ride a bike?

You can drive or cycle while taking terbinafine if you feel OK.

But if taking terbinafine makes you feel dizzy, tired or very unwell, do not drive or ride a bike until you feel OK again.

It’s an offence to drive a car if your ability to drive safely is affected. It’s your responsibility to decide if it’s safe to drive. If you’re in any doubt, do not drive.

Talk to your doctor or pharmacist if you’re unsure whether it’s safe for you to drive while taking or using terbinafine. GOV.UK has more information on the law on drugs and driving.

Can I drink alcohol while using or taking terbinafine?

Yes, you can drink alcohol while using or taking terbinafine.

Is there any food or drink I need to avoid?

Terbinafine tablets may increase the effects of caffeine. Having too much caffeine can give you headaches, stop you sleeping, make you feel agitated and it can make you pee more.

It’s a good idea to avoid having too much caffeine while taking the tablets. Caffeine is found in coffee, tea, colas, energy drinks and chocolate.

Other than this, you can eat and drink normally while using or taking terbinafine.

Can lifestyle changes help with fungal skin infections?

If you have a fungal skin infection, these tips may help:

• always wash your hands after treating the infection to stop it from spreading
• do not scratch the area with the infection, as this can make the infection worse
• keep the affected areas of your skin clean and dry
• do not share towels, bedsheets or combs with other people as you could spread the infection to them
• wash towels and bedding regularly

Read more about what you can do if you have:

• ringworm
• athlete’s foot
• a fungal nail infection

Page last reviewed: 24 March 2023

Next review due: 24 March 2026

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TERBINORM Spray: overcome fungus with ease

Increased the number of sunny days, the thermometer tends to rise, nature is actively changing, mood and, of course, our wardrobe is changing. More and more open things and contact with the outside world. With the onset of heat, the risk of trauma to the open skin of the feet and nails increases, the intense work of the body’s thermoregulation system leads to increased sweating, including the feet, and favorable conditions are formed for the development of a fungal infection. It is difficult to hide this not only a cosmetic problem, in addition, it becomes obvious to others. Therefore, it’s time to purchase a modern effective antifungal agent.

Among antifungal drugs, terbinafine has gained well-deserved popularity due to its pronounced fungicidal action against a wide range of dermatophytes, molds and dimorphic fungi, as well as its safety.

TERBINORM spray (manufactured in Romania) is a topical preparation of terbinafine for the treatment of fungal infections of the skin caused by dermatophytes of the genus Trichophyton , Microsporum canis and Epidermophyton floccosum . It is advisable to use the drug for such common mycoses as interdigital epidermophytosis of the feet (“athlete’s foot”), inguinal dermatophytosis (“jockey’s itch”), dermatophytosis of the body (ringworm), as well as for versicolor versicolor caused by Pityrosporum orbiculare ( Malassezia furfur ).

The mechanism of action of terbinafine is directed at the enzyme systems of the fungus, which have a low affinity for the human cytochrome system (Burbello A. T., 2007). That is why the drug does not affect the synthesis of human steroid structures (cholesterol, hormones) (Zaichenko A.V., 2013). Many drugs are metabolized by the cytochrome P450 system. Terbinafine has a significant metabolic neutrality and little enters into pharmacokinetic interactions with other drugs (Shtrygol S.Yu., 2006). Thus, terbinafine is the first choice antimycotic for patients receiving drug therapy for concomitant diseases (Vashchenko O.O. et al., 2009). In old age, it is necessary to take into account the severity of systemic action and, accordingly, possible systemic adverse reactions of the drugs used. TERBINORM Spray acts exclusively at the site of application, as less than 5% of the applied dose of terbinafine is absorbed.

The clinical course of mycosis is often complicated by the bacterial flora, so therapy should be complex and include drugs with antimicrobial and anti-inflammatory effects. In studies, a high activity of external forms of terbinafine against gram-positive and gram-negative bacteria was noted (Bolotnaya M. A., 2012). The spray shape allows you to evenly distribute the drug over the surface of the skin. TERBINORM spray is convenient and easy to use, provides quick treatment of fungal lesions, which is especially important in the presence of large lesions or their localization in skin folds, between the toes. It should be noted that in addition to the antifungal action, terbinafine has a high anti-inflammatory activity and pronounced antibacterial properties, and due to lipo- and keratophilicity, it is quickly absorbed into the skin, softening it (Klimova I.Ya. et al., 2007). The spray form has a refreshing, drying , anti-inflammatory and antipruritic effects. Another advantage of TERBINORM spray is that the drug is odorless, colorless and does not leave marks on clothes. The course treatment with TERBINORM spray is 7 days. The drug is used once a day, while creating therapeutic concentrations of terbinafine in the skin layers, which persist for up to 1 week, which determines the post-therapeutic effect of the drug.