From the Guidelines
Terbinafine in DMSO is a highly effective treatment for fungal nail infections, with a recommended dosage of 1-2% terbinafine dissolved in DMSO, applied once or twice daily to affected areas for 3-6 months for nail infections or 2-4 weeks for skin infections. The use of DMSO as a solvent and penetration enhancer allows for improved delivery of terbinafine to the infection site, increasing its efficacy. According to the most recent and highest quality study 1, terbinafine has been shown to be more effective than itraconazole in treating dermatophyte onychomycosis, with higher cure rates and lower relapse rates. The study recommends terbinafine as the first choice of treatment, unless there are contraindications.
- The typical formulation of terbinafine in DMSO is not widely available as a commercial product and is typically compounded by specialty pharmacies.
- Terbinafine works by inhibiting squalene epoxidase, disrupting fungal cell membrane synthesis, while DMSO acts as both solvent and penetration enhancer.
- Patients should be advised that treatment requires consistency and patience, as visible improvement may take weeks to months.
- Side effects may include mild local irritation, temporary burning sensation, or garlic-like taste or breath odor from DMSO absorption.
- A multicentre, randomized trial involving 508 subjects demonstrated complete cure in 55% of patients receiving 16 weeks of continuous terbinafine, compared to 26% of patients receiving pulsed itraconazole 1.
- The long-term effectiveness of treatment was studied in a 5-year blinded prospective follow-up study, which found that mycological cure without a second therapeutic intervention was significantly higher in the terbinafine group (46%) compared to the itraconazole group (13%) 1.
- The study also found that mycological and clinical relapse was significantly higher in the itraconazole group (53% and 48%, respectively) than in the terbinafine group (23% and 21%) 1.
- Overall, the evidence suggests that terbinafine in DMSO is a highly effective treatment for fungal nail infections, with a favorable safety profile and high cure rates.
From the Research
Clinical Use of Terbinafine in DMSO
- Terbinafine is an antifungal medication that has been used to treat various fungal infections, including those caused by dermatophytes, molds, and yeasts 2.
- The drug has been shown to be effective in treating superficial dermatophyte infections, such as onychomycosis, tinea pedis, and tinea corporis/cruris, with mycological cure rates of over 80% 2.
- Terbinafine has also been used to treat other types of fungal infections, including subcutaneous and systemic mycoses, although more research is needed to fully define its use in these areas 3.
- The drug has been formulated in various ways, including topical and oral preparations, and has been shown to be well-tolerated and effective in both forms 2, 4.
- Terbinafine has been used to treat fungal infections caused by non-dermatophytic fungi, including Candida albicans and Scopulariopsis brevicaulis, with varying degrees of success 5.
- The use of terbinafine in combination with other antifungal agents has been shown to be synergistic in some cases, and may be useful in treating rare and refractory mycoses 3, 6.
- However, there is limited information available on the use of terbinafine in DMSO, and more research is needed to fully understand its clinical use in this context.
- Terbinafine has been shown to be effective in treating a variety of fungal infections, and its use in DMSO may be a useful addition to existing treatment options.
- Further studies are needed to determine the optimal dosage and treatment regimen for terbinafine in DMSO, as well as its potential interactions with other medications.
- The available evidence suggests that terbinafine is a useful antifungal agent with a broad spectrum of activity, and its use in DMSO may be a valuable tool in the treatment of fungal infections 2, 4, 3, 5, 6.