Comparative Pharmacology
Head-to-head clinical analysis: LAMISIL AT versus MYCELEX G.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMISIL AT versus MYCELEX G.
LAMISIL AT vs MYCELEX-G
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.
Clotrimazole, an imidazole antifungal, inhibits fungal cytochrome P450 14α-demethylase, disrupting ergosterol synthesis and increasing membrane permeability.
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.
Clotrimazole 100 mg vaginal tablet inserted intravaginally once daily for 7 days or 200 mg once daily for 3 days; or 500 mg single dose. Also available as 1% vaginal cream, 1 applicatorful (5 g) intravaginally once daily for 7-14 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.
Biphasic: initial half-life ~30 minutes, terminal half-life ~30 hours; clinical significance: supports once-daily dosing for topical/vaginal formulations.
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; about 80-90% of dose excreted as metabolites in feces via biliary excretion, less than 1% unchanged in urine.
Category C
Category C
Antifungal
Antifungal