Comparative Pharmacology
Head-to-head clinical analysis: LAMISIL AT versus NILSTAT.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMISIL AT versus NILSTAT.
LAMISIL AT vs NILSTAT
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.
Nystatin binds to ergosterol in fungal cell membranes, forming pores that disrupt membrane integrity and cause leakage of intracellular contents, leading to 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.
Topical: Apply 100,000 units/g cream or ointment to affected area twice daily. Oral suspension: 100,000 units/mL; 4-6 mL swish and swallow four times daily for 14 days. Oral tablets: 500,000 units; 1-2 tablets three 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-defined due to minimal systemic absorption following oral or topical administration; estimated to be <1 hour in systemic circulation 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 via feces as unchanged drug; negligible urinary excretion (<1%).
Category C
Category C
Antifungal
Antifungal