From the Guidelines
For the treatment of tinea corporis, oral terbinafine is typically prescribed at a dose of 250 mg once daily for 2-4 weeks in adults. This dosage is based on the most recent and highest quality study available, which suggests that terbinafine is superior to other treatments for tinea corporis, including itraconazole and griseofulvin 1. For children, the dosage is weight-based: 10-20 kg: 62.5 mg daily; 20-40 kg: 125 mg daily; and over 40 kg: 250 mg daily, also for 2-4 weeks. Topical terbinafine 1% cream is an alternative, applied once or twice daily for 1-2 weeks.
Before starting treatment, it is essential to confirm the diagnosis, as misdiagnosis can lead to treatment failure. Patients should be advised to complete the full course even if symptoms improve earlier, and to keep the affected area clean and dry. Oral terbinafine works by inhibiting the enzyme squalene epoxidase, disrupting fungal cell membrane synthesis, while the topical formulation penetrates the stratum corneum effectively. Some key points to consider when treating tinea corporis with terbinafine include:
- The importance of completing the full treatment course, even if symptoms improve earlier
- The need to keep the affected area clean and dry
- The potential for side effects, including gastrointestinal disturbances, headache, and rarely, liver function abnormalities, which may require monitoring for extended treatment
- The superiority of terbinafine over other treatments, including itraconazole and griseofulvin, as demonstrated in studies 1.
It is also worth noting that terbinafine has a high cure rate and low relapse rate, making it a preferred treatment option for tinea corporis 1. Overall, the use of terbinafine for the treatment of tinea corporis is supported by strong evidence and is a recommended treatment option.
From the Research
Dosage of Terbinafine for Tinea Corporis
- The recommended dosage of terbinafine for the treatment of tinea corporis is 250 mg/day, as stated in the study 2.
- This dosage has been shown to be effective in achieving mycological cure in over 80% of patients with superficial dermatophyte infections, including tinea corporis 2.
- In another study, patients with tinea corporis/cruris were treated with 250 mg of oral terbinafine once daily for 2 weeks, resulting in a mycological response of 90.3% 3.
- A comparison study between terbinafine and griseofulvin found that terbinafine was more effective in the treatment of tinea corporis, with a higher clinical response and lower relapse rate 3, 4.
- The combination of oral terbinafine and itraconazole has also been shown to be effective in the treatment of dermatophytosis, including tinea corporis, with a clinical and mycological cure rate of 90% 5.
Treatment Duration
- The treatment duration for tinea corporis with terbinafine can vary, but studies have shown that 2-6 weeks of treatment can be effective 2, 3, 4.
- In one study, patients were treated with terbinafine for 2 weeks, with a follow-up evaluation at 6 weeks 3.
- Another study treated patients with terbinafine for 6 weeks, with a follow-up evaluation at the end of treatment 4.