What is the recommended dose of Terbinafine (Lamisil) for adults and pediatric patients?

From the Guidelines

The recommended dose of terbinafine (Lamisil) for adults is 250 mg once daily for 6 weeks for fingernail infections and 12 weeks for toenail infections. For adults with tinea corporis, tinea cruris, or tinea pedis, the recommended dose is 250 mg once daily for 2-4 weeks. For pediatric patients, dosing is weight-based:

• children weighing more than 40 kg should receive the adult dose of 250 mg daily;
• children 25-40 kg should receive 187.5 mg daily;
• children 20-25 kg should receive 125 mg daily;
• and children under 20 kg should receive 62.5 mg daily, as indicated by 1. The duration of treatment for children is similar to adults. Terbinafine works by inhibiting the enzyme squalene epoxidase, which disrupts fungal cell membrane synthesis, making it effective against dermatophytes. The medication should be taken with food to enhance absorption. Patients should be monitored for potential side effects including headache, gastrointestinal disturbances, and rarely, liver enzyme elevations, as noted in 1. Complete the full course of treatment even if symptoms improve before finishing, as premature discontinuation may lead to recurrence of infection. It's also important to consider the guidelines for the management of onychomycosis in pediatric populations, as outlined in 1, which provide additional information on the efficacy and safety of systemic treatment for pediatric onychomycosis. However, the most recent and highest quality study, 1, provides the most relevant guidance for dosing terbinafine in adults and pediatric patients.

From the FDA Drug Label

Patients should take one 250 mg tablet once daily for 6 weeks for treatment of fingernail onychomycosis or once daily for 12 weeks for treatment of toenail onychomycosis

The recommended dose of Terbinafine (Lamisil) for adults is 250 mg once daily. The treatment duration is 6 weeks for fingernail onychomycosis and 12 weeks for toenail onychomycosis 2.

From the Research

Recommended Dose of Terbinafine

The recommended dose of Terbinafine (Lamisil) varies for adults and pediatric patients.

• For adults, the recommended dose is 250 mg/day 3, 4.
• For pediatric patients, the dose is based on weight:
  • Children weighing less than 20 kg: 62.5 mg/day 5.
  • Children weighing 20-40 kg: 125 mg/day 5.
  • Children weighing more than 40 kg: 250 mg/day 5.

Special Considerations

• For the treatment of Microsporum canis tinea capitis, a doubled dose of oral terbinafine may be required 6.
• A pulse therapy regimen of 500 mg/day for 7 days every 3 months has been shown to be effective in treating onychomycosis caused by dermatophytes 7.

Key Points

• The dose and duration of treatment may vary depending on the specific fungal infection being treated.
• Terbinafine has been shown to be effective and well-tolerated in the treatment of various fungal infections, including onychomycosis and tinea capitis 3, 5, 4.