Comparative Pharmacology
Head-to-head clinical analysis: LAMISIL AT versus NATACYN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMISIL AT versus NATACYN.
LAMISIL AT vs NATACYN
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.
Natamycin is a polyene antifungal that binds to ergosterol in fungal cell membranes, increasing permeability and causing 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.
One drop of 5% ophthalmic suspension into the conjunctival sac every 1-2 hours for 48 hours, then taper to one drop 4-6 times daily.
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.
Not well characterized due to minimal systemic absorption; estimated to be 2-3 hours in plasma if absorbed.
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 fecal via biliary elimination; less than 5% renal excretion of absorbed dose.
Category C
Category C
Antifungal
Antifungal, Ophthalmic