Exifin

Exifin is an antifungal drug.

Indications Exifin

It is indicated for the elimination of fungi on the skin, hair, and nails (caused by the action of dermatophytes).

Release form

Available in tablet form - 4 tablets per blister. One package contains 4 blister strips.

Pharmacodynamics

The active substance of the drug is terbinafine hydrochloride - a synthetic element included in the group of allylamines and possessing a wide range of antifungal effects. At low concentrations, terbinafine acquires fungicidal activity against individual molds, as well as dimorphic fungi, and also against dermatophytes. In relation to yeast fungi, the substance has a fungistatic or fungicidal effect (depending on the type of fungus).

The mechanism of action of the drug is due to its ability to inhibit the early stages of sterol binding inside the membranes of fungal cells. The substance contributes to a deficiency of ergosterol, as well as the accumulation of squalene inside the cells - as a result, this causes the death of the fungus.

Pharmacokinetics

After oral administration, the substance accumulates in hair follicles, skin, and nail plates. The bioavailability of the drug increases if it is taken with food. The concentration of the drug in the plasma reaches its maximum 2 hours after administration.

More than 99% of the active component dosage is synthesized with plasma protein.

Terbinafine is metabolized in the liver, resulting in derivatives that have no pharmacological activity.

The substance is mainly excreted through the kidneys in the form of derivatives. The half-life is 30 hours.

No significant differences in the pharmacokinetics of the substance depending on the patient's age group have been established. Liver or kidney disorders may cause changes in the rate of excretion of the component from the body.

Dosing and administration

You need to take the tablets before or after meals. Dosages, the regimen, and the duration of use of the drug are prescribed by the attending physician, who takes into account the nature of the pathology, as well as its severity.

For children weighing 40+ kg, as well as adults, when treating mycoses, it is usually prescribed to take 1 tablet of the medicine per day.

The duration of treatment for the elimination of mycosis on the scalp is 1 month, and for the elimination of ringworm on smooth skin or candidiasis on the skin is 0.5-1 month.

To eliminate mycosis on the feet, it is necessary to use the drug for 2-6 weeks (the exact period depends on the condition of the skin, as well as the pathogen that caused the disease).

The duration of therapy for onychomycosis (a fungus that affects the nail plates) is 6-12 weeks. The duration of the course usually depends on how fast the nails grow, because in such diseases, as a rule, it is recommended to use the medicine until the healthy nail has completely grown out.

Clinical manifestations of the disease may disappear after a few days from the start of therapy, but it is necessary to continue taking the pills for the entire period prescribed by the doctor. If you stop therapy prematurely or take the pills irregularly, the pathology may relapse.

If the drug is taken for a long time, it is necessary to monitor peripheral blood counts, as well as liver function.

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Use Exifin during pregnancy

Pregnant women should not take the medicine.

During lactation, the use of terbinafine is also not recommended. If you cannot refuse to take the drug, you must stop breastfeeding for the period of treatment.

Contraindications

The medicine should not be taken in case of hypersensitivity to terbinafine or other components of the medicine.

Contraindications include the presence of liver pathologies in the patient (also if they are present in the anamnesis), and also renal failure (if the creatinine clearance rate is below 50 ml/min).

It is prohibited to prescribe the medicine to children under 12 years of age (the child's weight should also not be less than 40 kg).

Side effects Exifin

The use of the drug may cause the following side effects:

• organs of the hematopoietic system: thrombocyto-, pancyto- and neutropenia, as well as agranulocytosis;
• nervous system organs: the appearance of dizziness and headaches, as well as paresthesia or hypoesthesia and taste bud disorders;
• digestive system organs: loss of appetite, dyspepsia, nausea, abdominal pain, bowel disorders, and a feeling of fullness in the stomach;
• liver, as well as biliary tract organs: increased activity of liver enzymes, development of hepatitis or jaundice. A weakening of liver function (up to the development of liver failure with subsequent death) was observed in isolated cases in people suffering from a disorder in the functioning of this organ (but it was not possible to confirm a connection between death due to liver failure and the use of terbinafine);
• allergies: development of urticaria, Lyell's syndrome, erythema multiforme, as well as acute generalized exanthematous pustulosis and angioedema, as well as lupus erythematosus;
• other: myalgia and arthralgia, severe fatigue, and in addition, exacerbation of psoriasis.

Occasionally, severe hair loss was observed, but it was not possible to link the alopecia to the use of the tablets.

If the patient has side effects, it is necessary to consult a doctor to determine the advisability of further treatment with Exifin. In case of deterioration of liver function, change in activity, as well as the level of liver enzymes, as well as in case of dyspepsia, constant nausea and changes in the indicators of formed blood elements, the use of the drug should be discontinued.

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Overdose

The use of Exifin in high doses can cause symptoms such as nausea with vomiting, pain in the epigastric region, dizziness with headaches, skin rashes, and polyuria.

The drug has no specific antidote. If overdose occurs, the drug should be discontinued and treatment should be given to eliminate the symptoms.

Interactions with other drugs

Medicines that slow down or induce enzymes that are part of the hemoprotein P450 system, in combination with Exifin, are capable of changing the concentration of the unchanged active substance of the latter in the plasma. If it is impossible to refuse to take such drugs in combination, it is necessary to monitor the terbinafine indicators, and also adjust the dosage of Exifin, if necessary.

The combined use of terbinafine and warfarin may change the prothrombin time, reduce the effectiveness of the drug, and also increase the risk of bleeding. If long-term use of these drugs together is required, it is necessary to monitor the prothrombin time and adjust the dosage of warfarin.

Combination with rifampicin increases the clearance rate of terbinafine by 100%.

When Exifin is used simultaneously with drugs whose metabolism occurs with the help of enzymes of the hemoprotein P450 system, some change in the pharmacokinetic properties of the latter is possible.

The drug does not affect the pharmacokinetics of antipyrine or digoxin.

Terbinafine reduces the clearance rate of caffeine by 19% (parenteral forms of the latter).

The combination of the drug with tricyclics, β-adrenergic receptor blockers, selective serotonin reuptake inhibitors, as well as with antiarrhythmic drugs (categories 1A, 1B, 1C) and MAO inhibitors (type B) may slightly increase the concentration of the above drugs in the plasma.

When Exifin is used simultaneously with desipramine, the clearance rate of the latter decreases by 82%.

As a result of the combination with terbinafine, a decrease in the cyclosporine clearance coefficient (by 15%) is also observed.

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Storage conditions

The medicine must be kept in normal conditions for medicines, inaccessible to small children. Temperature – within 15-25 ^o C.

Shelf life

Exifin is permitted to be used for 3 years from the date of its release.