Comparative Pharmacology
Head-to-head clinical analysis: DIFLUCAN versus LAMISIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DIFLUCAN versus LAMISIL.
DIFLUCAN vs LAMISIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Diflucan (fluconazole) is a triazole antifungal agent that inhibits fungal cytochrome P450 14-alpha-demethylase, thereby blocking the conversion of lanosterol to ergosterol, an essential component of the fungal cell membrane. This leads to increased membrane permeability and inhibition of fungal growth.
Allylamine antifungal that inhibits squalene epoxidase, an enzyme in the ergosterol biosynthesis pathway, leading to accumulation of squalene and disruption of fungal cell membrane function.
Oral or IV: 200-400 mg loading dose, then 100-200 mg once daily. Dose and duration depend on indication.
250 mg orally once daily for 2-6 weeks for dermatophyte infections; 250 mg orally once daily for 12 weeks for onychomycosis.
None Documented
None Documented
30 hours (range 20-50 hours); prolonged in renal impairment (up to 98 hours in CrCl <20 mL/min)
Terminal elimination half-life is approximately 17-24 hours in healthy adults. However, it can prolong to about 36-40 hours in patients with renal or hepatic impairment. The prolonged half-life allows for once-daily dosing. Due to extensive tissue distribution, the functional half-life (terminal phase from tissues) may be longer.
Renal: 80% unchanged; fecal/biliary: 11% as metabolites
Approximately 70% of the administered dose is excreted in the urine as metabolites, with less than 5% as unchanged drug. About 20% is eliminated via feces. Terbinafine undergoes extensive hepatic metabolism; renal elimination of metabolites is the primary route.
Category C
Category C
Antifungal
Antifungal