Comparative Pharmacology
Head-to-head clinical analysis: LAMISIL AT versus MONISTAT 7.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMISIL AT versus MONISTAT 7.
LAMISIL AT vs MONISTAT 7
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, an imidazole antifungal, inhibits fungal cytochrome P450 14α-demethylase, reducing ergosterol synthesis and disrupting fungal cell membrane integrity.
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.
Intravaginal administration of 100 mg miconazole nitrate suppository once daily at bedtime for 7 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 elimination half-life is approximately 24-30 hours following intravaginal administration; clinical significance: supports once-daily dosing.
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 via feces (approximately 87-93% of dose) as unchanged drug and metabolites; renal excretion negligible (<1%).
Category C
Category C
Antifungal
Antifungal