Comparative Pharmacology
Head-to-head clinical analysis: LAMISIL AT versus MICONAZOLE 3.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMISIL AT versus MICONAZOLE 3.
LAMISIL AT vs MICONAZOLE 3
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Miconazole inhibits fungal cytochrome P450 14α-demethylase (CYP51), thereby blocking the conversion of lanosterol to ergosterol, an essential component of the fungal cell membrane. This leads to increased membrane permeability, leakage of cellular contents, and fungal cell death.
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.
For vaginal candidiasis: 200 mg (one suppository) intravaginally at bedtime for 3 consecutive days.
None Documented
None Documented
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.
Terminal half-life is approximately 24 hours (range 20-30 hours) following topical vaginal application; prolonged in hepatic impairment.
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.
Primarily hepatic metabolism; <1% excreted unchanged in urine; fecal elimination accounts for ~50% of metabolites.
Category C
Category A/B
Antifungal
Antifungal