Comparative Pharmacology
Head-to-head clinical analysis: LAMISIL AT versus NYSTEX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMISIL AT versus NYSTEX.
LAMISIL AT vs NYSTEX
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 lead to leakage of intracellular contents and 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 thin layer to affected area twice daily. Oral suspension (nystatin): 500,000-1,000,000 units (5-10 mL) four times daily for candidiasis. Vaginal tablets: 1 tablet (100,000 units) intravaginally once daily for 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.
Variable; estimated 2-5 hours for systemic absorption (if any), but negligible systemic levels due to poor absorption.
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 (>95%) as unchanged drug; minimal renal excretion (<1%).
Category C
Category C
Antifungal
Antifungal