From the Guidelines
Loss of taste, or hypogeusia, is a potential side effect of certain antifungal medications, particularly oral antifungals like terbinafine, with a reported incidence of reversible taste disturbance in 1:400 patients 1.
Association Between Antifungal Medications and Hypogeusia
The association between antifungal medications and the development of hypogeusia is supported by evidence from studies on the side effects of these medications.
- Terbinafine, an allylamine antifungal, has been reported to cause taste disturbances in some patients, although this is considered a rare side effect 1.
- The mechanism behind this side effect is not fully understood, but it is thought to involve the medication affecting taste receptors or the nerves that transmit taste signals to the brain.
- Other oral antifungals, such as itraconazole and fluconazole, may also be associated with taste disturbances, although the evidence is less clear.
Management of Hypogeusia in Patients Taking Antifungal Medications
If a patient experiences loss of taste while taking an antifungal medication, it is essential to consult their healthcare provider before stopping the treatment.
- The healthcare provider may recommend completing the full course of treatment if the infection is severe, or switching to a different antifungal with fewer taste-altering properties.
- Patients can also try managing taste disturbances by staying well-hydrated, practicing good oral hygiene, and using sugar-free mints or gum.
- If taste changes persist for more than two weeks after stopping the medication, patients should follow up with their healthcare provider for further evaluation 1.
Conclusion is not allowed, so the answer will be ended here.
From the FDA Drug Label
Taste disturbance, including taste loss, has been reported with the use of terbinafine tablets. Taste disturbance can be severe, may be prolonged, or may be permanent. Taste Perversion 6 (1%)
- Association between antifungal medications and hypogeusia: There is an association between the use of antifungal medications, specifically terbinafine 2 and fluconazole 3, and the development of hypogeusia (loss of taste).
- Key findings:
From the Research
Association between Antifungal Medications and Hypogeusia
- There is evidence to suggest an association between the use of antifungal medications and the development of hypogeusia (loss of taste) 4.
- A study published in 2005 found that terbinafine, an oral antifungal agent, induced taste loss in 0.6% to 2.8% of patients taking the drug 4.
- The study used quantitative taste and smell tests to assess chemosensory function in six patients complaining of taste disturbance after terbinafine treatment and found that taste function was significantly depressed in both the anterior and posterior lingual regions 4.
- Another study published in 2001 reported that terbinafine caused taste disturbance in 2 patients 5.
- The 2017 Cochrane review of oral antifungal treatments for toenail onychomycosis reported that common adverse events included taste loss and nausea in terbinafine-treated participants 6.
Mechanism and Prevalence
- The exact mechanism of antifungal medication-induced hypogeusia is not well understood, but it is thought to be related to the drug's effect on the taste buds or the nervous system 4.
- The prevalence of antifungal medication-induced hypogeusia is likely underreported, as many cases may go undiagnosed or unreported 4.
- Risk factors for terbinafine-induced taste loss include being older than 65 years of age and having a low body mass index 4.
Comparison of Antifungal Medications
- The 2017 Cochrane review compared the efficacy and safety of different oral antifungal treatments, including terbinafine, azoles, and griseofulvin 6.
- The review found that terbinafine and azoles were effective treatments for toenail onychomycosis, but terbinafine may have a better safety profile 6.
- Griseofulvin was found to have a higher risk of adverse events, including gastrointestinal disturbance and allergic reaction 6.