What is the dosage of Terbinafine (an antifungal medication) for a pediatric patient?

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From the Guidelines

The dosage of Terbinafine for a pediatric patient is 625 mg per day if weight is < 20 kg, 125 mg per day for 20–40 kg weight, and 250 mg per day for > 40 kg.

Key Considerations

  • The dosage is based on the patient's weight, with different doses recommended for different weight ranges 1.
  • The treatment duration is 6 weeks for fingernail infection and 12 weeks for toenail infection 1.
  • It is essential to monitor baseline liver function tests and a complete full blood count in pediatric patients, as Terbinafine is unlicensed for use in children 1.
  • The evidence suggests that Terbinafine is well tolerated in pediatric populations, with common adverse reactions including headache, taste disturbance, and gastrointestinal upset 1.

Treatment Guidelines

  • The British Association of Dermatologists' guidelines recommend Terbinafine as a first-line treatment for dermatophyte onychomycosis in pediatric patients 1.
  • The guidelines also suggest that pulse itraconazole therapy and fluconazole may be considered as alternative treatments, depending on the specific circumstances 1.

From the Research

Dosage of Terbinafine for Pediatric Patients

The dosage of Terbinafine for pediatric patients varies based on weight and the specific fungal infection being treated.

  • For children weighing less than 20 kg, a dose of 62.5 mg/day is recommended 2.
  • For children weighing between 20-40 kg, a dose of 125 mg/day is recommended 2.
  • For children weighing more than 40 kg, the adult dose of 250 mg/day is appropriate 2.

Treatment Duration

The treatment duration for Terbinafine in pediatric patients also varies based on the specific fungal infection being treated.

  • For tinea capitis, a treatment duration of 4 weeks is recommended 3, 2, 4.
  • For other dermatophyte infections, the treatment duration may be shorter or longer, depending on the severity of the infection and the patient's response to treatment 5.

Efficacy and Safety

Terbinafine has been shown to be effective and safe in pediatric patients, with cure rates of over 90% reported in some studies 2, 4, 5.

  • The most common adverse reactions reported in pediatric patients include gastrointestinal symptoms, such as nausea and diarrhea, and skin reactions, such as rash and itching 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Overview of the use of terbinafine (Lamisil) in children.

The British journal of dermatology, 1995

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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