Comparative Pharmacology
Head-to-head clinical analysis: LAMISIL AT versus NYSTAFORM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMISIL AT versus NYSTAFORM.
LAMISIL AT vs NYSTAFORM
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.
1 tablet (nystatin 100,000 units) orally three times daily after meals. Each tablet should be allowed to dissolve slowly in the mouth.
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.
Plasma half-life is not measurable due to negligible systemic absorption. Topical or oral administration results in local action only; no systemic half-life is clinically relevant.
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.
Nystatin is not absorbed from the gastrointestinal tract, intact skin, or mucous membranes. After oral administration, it is excreted almost entirely unchanged in feces (over 99%). Minimal renal excretion occurs (less than 1%).
Category C
Category C
Antifungal
Antifungal