Comparative Pharmacology
Head-to-head clinical analysis: LAMISIL AT versus NYSTATIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMISIL AT versus NYSTATIN.
LAMISIL AT vs NYSTATIN
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 sterols in the fungal cell membrane, primarily ergosterol, altering membrane permeability and causing leakage of intracellular components, 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.
Oral: 500,000 to 1,000,000 units (5-10 mL suspension) swish and swallow 3-4 times daily; Vaginal: 1 vaginal tablet (100,000 units) once or twice daily; Topical: Apply cream/ointment 2-3 times daily; duration depends on indication.
None Documented
None Documented
Clinical Note
moderateNystatin + Tranilast
"The risk or severity of adverse effects can be increased when Nystatin is combined with Tranilast."
Clinical Note
moderateNystatin + Tolfenamic acid
"The risk or severity of adverse effects can be increased when Nystatin is combined with Tolfenamic acid."
Clinical Note
moderateNystatin + Nimesulide
"The risk or severity of adverse effects can be increased when Nystatin is combined with Nimesulide."
Clinical Note
moderateNystatin + Risedronic acid
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.
Due to minimal systemic absorption, a terminal elimination half-life is not clinically relevant. In vitro plasma degradation half-life is approximately 1.5 hours, but this is not applicable in vivo.
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 after oral administration; virtually 100% of the ingested dose is excreted unchanged in the feces. After topical application, systemic absorption is negligible; any absorbed drug is excreted via bile and feces (<1% renal).
Category C
Category A/B
Antifungal
Antifungal
"The risk or severity of adverse effects can be increased when Nystatin is combined with Risedronic acid."