Terbinafine vs Clotrimazole
Terbinafine vs Clotrimazole discusses the similarities and differences between Lamisil and Lotrimin.
Lamisil and lotrimin are both drugs used for the treatment of fungal infections.
They both come in different pharmaceutical dosage forms. These include:
- Lamisil tablets, cream,
- Lotrimin cream (topical and vaginal), troche and lozenges
Lamisil and lotrimin come also in different strengths. Their commonly available strength include the following:
- Lamisil:
- Tablets: 250 mg
- Packets, oral granules: 125 mg and 187.5 mg. These have been discontinued.
- Cream: 1%
- Lotrimin:
- Topical cream, ointment and solution: 1%
- Vaginal cream: 1% and 2%
- Troche: 10 mg
- Lozenges: 10 mg
Terbinafine vs Clotrimazole: composition
Terbinafine: Terbinafine hydrochloride is the pharmaceutical active ingredient of this preparation.
Clotrimazole: clotrimazole on the other hand is the pharmaceutical active ingredient of this preparation.
They both contain inactive ingredients called excipients in sufficient quantities.
Terbinafine vs Clotrimazole: uses
Broadly speaking, they are both used for the treatment of fungal infections.
Now, let’s look into detail the exact type of fungal infections they are both used to treat.
Terbinafine uses
Terbinafine is indicated for the treatment of Onychomycosis of toenails and fingernails due to dermatophytes (tinea unguium)
Its off label uses include the following:
- Sporotrichosis, Lymphocutaneous and cutaneous
- Tinea Corporis
- Tinea Cruris
- Tinea Pedis
Clotrimazole uses
Clotrimazole cream, ointment, solutions and tablets are used for the treatment of the following fungal infections:
- Vaginal Candidiasis (vaginal cream 1 or 2%)
- Cutaneous Candidiasis/ Dermatophytosis
- Tinea versicolor
- Superficial Dermatologic Infection
Terbinafine vs Clotrimazole: Dosage
We will be discussing the dosage of both drugs individually.
Unless otherwise stated, the given dosage is for adults and children from 12 years of age
We will be starting with Lamisil
Terbinafine dosage
Adult dosage
- Onychomycosis: 250 mg taken orally daily for 6 weeks (fingernail) or 12 weeks (toenail)
- Tinea Pedis: 250 mg/day taken orally in single dose or divided 12 hourly for 2-6 weeks
- Tinea Corporis and Tinea Cruris: 250 mg/day taken orally in single dose or divided 12 hourly for 2-4 weeks
- Sporotrichosis, Lymphocutaneous and cutaneous: 500 mg/day taken orally 12 hourly for 2-6 weeks.
- Treatment should be continued for additional 2-4 weeks after resolution of all lesions. Note that resolution may take 3-6 months.
Paediatric dosage
- Tinea Capitis:
- Children who are more than 4 years but weigh less than 25 kg: give 125 mg/day orally for 6 weeks
- Children who are more than 4 years but weigh between 25-35 kg: give 187.5 mg/day orally for 6 weeks
- Children who are more than 4 years but weigh more 35 kg: give 250 mg/day orally for 6 weeks
Clotrimazole dosage
Adults
- Cutaneous Candidiasis/ Dermatophytosis: apply to the affected part 12 hourly.
- Vaginal Candidiasis
- 1% vaginal Cream: Insert 1 applicatorful daily for 7-14 days
- 2% vaginal Cream: Insert 1 applicatorful daily for 3 consecutive days
- Vaginal cream that is dosed once daily is preferably used at bed time
- Superficial Dermatologic Infection: apply to the affected part 12 hourly for 7 consecutive days
Paediatric
The safety of Lotrimin is not established in children below 12 years of age
Terbinafine vs Clotrimazole: Side effects
Terbinafine and Clotrimazole have some side effects in common. They equally have some side effects that are peculiar to them individually.
Terbinafine side effects
- Headache
- Rash
- Pruritus
- Nausea
- Diarrhea
- Taste disturbance
- Abdominal pain
- Dyspepsia
- Elevated liver function test results
- Visual disturbance
Clotrimazole side effects
- General irritation of the skin
- Burning
- Pruritus
- Edema
- Erythema
- Blistering
- Peeling
- Urticaria
- Stinging
- Skin fissures
- Elevated serum AST (SGOT) concentrations (15%)
Terbinafine vs Clotrimazole: use in pregnancy and breastfeeding
Can these drugs be used while pregnant or by breastfeeding women?
Terbinafine
- Available data is not enough.
- Use a safer alternative. Otherwise, use with caution.
Clotrimazole
Use with caution as small amount of clotrimazole may be absorbed into the systemic circulation following the use of Lotrimin topical or vaginal Cream.
Terbinafine vs Clotrimazole: drug interactions
The following are drugs that interact with Terbinafine and Clotrimazole individually:
Terbinafine
- Saccharomyces boulardii: use alternative antifungal drug
- Metoclopramide intranasal: use alternative antifungal drug
- Rifampin reduces oral terbinafine blood concentrations.
- Cimetidine may increase oral terbinafine serum levels
- Fluconazole increases the blood levels of oral terbinafine
Clotrimazole
Immunosuppressants (Tacrolimus, Sirolimus): Using Lotrimin together with immunosuppressive drugs may lead to increased plasma levels of the immunosuppressive agents.
When it is important and unavoidable to use them together, please monitor patient closely for symptoms of tacrolimus or sirolimus overdosage.
Contraindications
Terbinafine
- Hypersensitivity to Lamisil or any of its components
- Chronic or active liver disease
Clotrimazole
- Hypersensitivity to imidazoles or any of the components of Lotrimin
Terbinafine vs Clotrimazole: Which is more effective?
For the treatment of fungal infections, both drugs are very effective.
However, Lamisil is more effective. But then, it is reserved for serious infections or where Lotrimin is not effective.
Which is better?
Both Terbinafine and Clotrimazole are good agents for the treatment of susceptible fungal infections.
Since Terbinafine is more effective than Lotrimin, it is right to say that it is still better.
The comparison is based on cure rate and effectiveness only.
Note however that they both have where they’re best indicated.
Is Terbinafine and Clotrimazole the same?
They are not the same but similar.
Terbinafine contains terbinafine hydrochloride while Clotrimazole contains clotrimazole as their respective active ingredients.
Although, they are both antifungal drugs and therefore used for the treatment of susceptible fungal infections.
Pictures
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