Pulsed versus continuous terbinafine dosing in the treatment of dermatophyte onychomycosis

The Journal of Dermatological Treatment
F PavlotskyH Trau

Abstract

The accepted regimen for terbinafine, one of the most effective treatments for dermatophyte onychomycosis, is continuous administration of 250 mg/day over 16 weeks. A few small studies, however, have raised the possibility of an alternative regimen: pulsed administration of 500 mg/day for 1 week, every 4 weeks (over 16 weeks), without decreasing treatment efficacy. Our aim was to compare the efficacy and safety of both regimens in a large group of patients. Retrospective analysis of 260 patients with culture proven dermatophyte onychomycosis treated in seven outpatient clinics run by two dermatologists using one of the terbinafine protocols on a chronological basis: 105 patients were treated using the continuous regimen during 1998/1999 and 155 patients were treated using the pulsed regimen during 1999/2002. Mycological and clinical cure were assessed 2 and 3 months, respectively, after completion of the last therapeutic course. Side effects were documented for the pulse regimen group only and compared with historical data previously published for the continuous protocol. The mycological, clinical and complete (mycological and clinical) cure rates of the toenails were 72.1%, 53.5% and 47.1% in the pulse regimen versus 82%, 35% ...Continue Reading

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Citations

Jun 27, 2006·Dermatologic Clinics·Aditya K Gupta, Linh Q Tu
May 15, 2009·Journal of the European Academy of Dermatology and Venereology : JEADV·A K GuptaE A Cooper
May 1, 2012·Mycoses·Chander Grover, Ananta Khurana
May 29, 2012·Journal of the European Academy of Dermatology and Venereology : JEADV·A K GuptaA Tavakkol
Sep 4, 2007·The American Journal of Medicine·Chia-Hsuin ChangArnold K Chan
Nov 22, 2005·Expert Opinion on Drug Delivery·Matilde IorizzoAntonella Tosti
Jun 19, 2015·Indian Journal of Dermatology, Venereology and Leprology·Pravesh YadavShukla Das
Jun 18, 2016·Journal of Cutaneous Medicine and Surgery·Aditya K GuptaKelly A Foley
Apr 4, 2007·Dermatologic Therapy·Justin J Finch, Erin M Warshaw
Jul 27, 2011·Medical Mycology Journal·Takashi Harada

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