Comparative Pharmacology
Head-to-head clinical analysis: LAMISIL AT versus SPORANOX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMISIL AT versus SPORANOX.
LAMISIL AT vs SPORANOX
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.
Inhibits fungal cytochrome P450 (CYP450)-dependent lanosterol 14α-demethylase, blocking ergosterol synthesis and disrupting fungal cell membrane integrity.
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.
200 mg orally twice daily for 3-7 days; for onychomycosis: 200 mg orally once daily for 12 weeks.
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.
The terminal elimination half-life of itraconazole ranges from 21 to 35 hours for single doses, increasing to approximately 34 to 42 hours at steady state. The half-life of the active metabolite, hydroxyitraconazole, is similar. This long half-life allows for once-daily or twice-daily dosing in most indications.
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.
Itraconazole is extensively metabolized in the liver via CYP3A4 to active metabolites, including hydroxyitraconazole. The parent drug and metabolites are primarily excreted in feces (approximately 54%) and urine (approximately 35%), with less than 1% of the dose excreted unchanged in urine.
Category C
Category C
Antifungal
Antifungal