Comparative Pharmacology
Head-to-head clinical analysis: AMPHOTERICIN B versus LAMISIL AT.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMPHOTERICIN B versus LAMISIL AT.
AMPHOTERICIN B vs LAMISIL AT
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Binds to ergosterol in fungal cell membranes, forming pores that increase permeability and cause leakage of intracellular contents, leading to cell death.
Terbinafine inhibits squalene epoxidase, an enzyme in the fungal ergosterol biosynthesis pathway. This leads to accumulation of squalene and depletion of ergosterol, disrupting fungal cell membrane integrity and causing cell death.
0.5-1.5 mg/kg/day IV over 2-6 hours; for invasive aspergillosis, 1 mg/kg/day; for cryptococcal meningitis, 0.7 mg/kg/day IV in combination with flucytosine; liposomal formulation: 3-5 mg/kg/day IV. Maximum dose: 1.5 mg/kg/day for conventional amphotericin B deoxycholate.
Terbinafine 250 mg orally once daily for 6 weeks for fingernail onychomycosis or 12 weeks for toenail onychomycosis. Topical: 1% cream applied once daily for 1 week for tinea pedis; 1% solution applied once daily for 1 week for tinea corporis/cruris.
None Documented
None Documented
Clinical Note
moderateAmphotericin B + Digoxin
"The risk or severity of adverse effects can be increased when Amphotericin B is combined with Digoxin."
Clinical Note
moderateAmphotericin B + Digitoxin
"The risk or severity of adverse effects can be increased when Amphotericin B is combined with Digitoxin."
Clinical Note
moderateAmphotericin B + Deslanoside
"The risk or severity of adverse effects can be increased when Amphotericin B is combined with Deslanoside."
Clinical Note
moderateTerminal half-life: 24–48 hours initially, prolonged to 15 days with repeated dosing due to tissue redistribution.
The terminal elimination half-life is approximately 11-17 hours in healthy adults; however, it increases to about 200-400 hours in the distribution phase from tissues (e.g., skin, adipose). Steady-state is reached after 10-14 days of oral dosing.
Renal: ~2-5% unchanged; biliary/fecal: ~40% as metabolites; extensive tissue binding delays excretion.
Terbinafine is extensively metabolized in the liver; approximately 80% of a dose is excreted in urine as metabolites, and 20% in feces. Less than 1% is excreted unchanged in urine.
Category C
Category C
Antifungal
Antifungal
Amphotericin B + Acetyldigitoxin
"The risk or severity of adverse effects can be increased when Amphotericin B is combined with Acetyldigitoxin."