Terbinafine vs Clotrimazole

Terbinafine vs Clotrimazole
Flow of Topics

Table of Contents

What is Terbinafine?

Terbinafine belongs to the antifungals class of medication. It works by preventing fungi from growing. It’s used to treat fungal (yeast)-related skin illnesses, such as:

  • Athlete’s foot
  • Fungal nail infection
  • Jock itch ringworm (sometimes called dhobie itch, an infection in the groin area)
  • Pityriasis versicolor is a kind of pityriasis (this causes small patches of scaly and discoloured skin often observed on your back, chest, upper arms, neck, and tummy)

Terbinafine is used to treat pityriasis versicolor, jock itch, and ringworm as a cream, gel, or spray. A fluid (solution) is also available for the athlete’s foot. It can be purchased from pharmacy and supermarket.(Balfour, J.A. and Faulds,)

What is Clotrimazole?

Clotrimazole is over counter medicine used as an antifungal medicine. It works against skin infections caused due to fungi (Gallagher, H.C., 2014).

Clotrimazole can be used for the treatment of different types of fungal infections, including:

  • Rash in folds of skin
  • Fungal nail infection
  • Ringworm
  • Thrush
  • Athlete’s foot
  • Infected nappy rash

Uses

Terbinafine

This medicine can be consumed meal as directed by your doctor. Dosage and duration of medication are determined by your medical condition and response to treatment.

 This medicine may take several months to work after you stop taking it. It will take time for new healthy nails to grow and replace the infected nails.

 Keep taking this medicine until your prescription is finished. Terminating the medication in the early stage can make the fungus grow and the infection might come back.

Clotrimazole

This medicine should be used externally only. This medication should be applied to the affected area of the skin twice a day or as directed by your doctor.

The type of infection to be treated determines the dose and duration of treatment. It should not be used more than once in a day. Your illness will not improve any faster, but the severity of your side effects may get worse.

Cover the affected area and part of the surrounding skin with enough medication. Wash your hands after using this medicine. Unless your doctor tells you otherwise, do not wrap, cover, or bandage the affected area.

 This medication must not be used in the eyes, nose, mouth, or vaginal area. You can order Clotrimazole online from a certified online pharmacy but consult your health provider before taking any medications.

Save Big On Terbinafine Medicines

Mechanism of Action

Terbinafine

Most antifungal drugs work by blocking fungal film formation and ergosterol synthesis. Terbinafine is an allylamine that acts as a non-completive inhibitor of squalene epoxidase and the subsequent conversion of squalene-to-squalene epoxide at the initiation of the pathway. 

 The intracellular accumulation of squalene causes fungal cell death, despite the fact that it has no immediate fungicidal effect.

Clotrimazole

Clotrimazole works by disrupting the permeability barrier in the cytoplasmic membrane of fungal cells. Clotrimazole blocks ergosterol formation by preventing demethylation of alpha lanosterol in a concentration-dependent manner.

Cells can no longer make complete and functional cell membranes when ergosterol synthesis is blocked. In terms of hormones, ergosterol also promotes fungal cell growth; Thus, the rapid onset of previous events resulted in dose-dependent inhibition of fungal growth.

Clotrimazole has antifungal properties by inhibiting ergosterol production, but it also has other pharmacological effects. These include blockade of calcium-dependent and potential-dependent calcium channels, as well as inhibition of the ca2+ ATPase substrate network and intracellular calcium depletion.

The action of clotrimazole on several cellular targets explains the additional effects of the drug, unrelated to its antispasmodic properties.

Forms and Strength

Terbinafine

It is also available in tablet form to treat nail fungus and other fungal diseases. If your doctor thinks creams, gels, sprays, or solutions aren’t working, they may recommend pills.

Terbinafine granules are applied to the scalp to treat fungal infections. Terbinafine pills are accustomed to treating toenail and fingernail fungal infections.

Terbinafine: 250mg

Terbinafine tablets can only be purchased with a doctor’s prescription.

Clotrimazole

Clotrimazole is available in the form of cream, spray, and solution that can be applied on skin.

Clotrimazole: Troche- 10mg

                        Lozenge – 10mg

Dosage

Terbinafine

Disease

Strength & Dosage

Onychomycosis

Fingernail

250mg for 6weeks

Toenail

250mg for 12weeks

Tinea Pedis (Off Label)

Orally 250mg/day single dose or divided every 12hours for 2-6weeks

Tinea Corporis

Orally 250mg/day single dose or divided every 12hours for 2-4weeks

Sporotrichosis, Lymphocutaneous and cutaneous (Off-label)

Orally 500mg/day after every 12hours for 2-6weeks. Can be continued for additional 2-4 weeks after resolution of all lesions.

Tinea Capitis, Pediatric

Less than 25kg weight

125 mg/day orally for 6 weeks

25-35Kg weight

187.5 mg/day orally for 6 weeks

Greater than 35kg weight

250 mg/day orally for 6 weeks

 

Clotrimazole

Disease

For

Application

cutaneous candidiasis

Adults

It can be applied to the affected skin and surrounding areas two times a day.

Children and Adolescents

It can be applied to the affected skin and surrounding areas two times a day.

oropharyngeal candidiasis (thrush)

Adults

10 mg PO 5 times daily for 1-2 weeks.

Children and Adolescents 3-17 Years

10 mg PO 5 times daily for 1-2 weeks.

vulvovaginal candidiasis 

Adult females

1 applicatorful of 1% cream (50 mg) vaginally at bedtime for 7 days 

Adolescent females 12 to 17 years

1 applicatorful of 1% cream (50 mg) vaginally at bedtime for 7 days 

Tinea corporis, Tinea cruris, and Tinea pedis

Adults

It should be applied to the infected skin and surrounding areas twice daily.

Children and Adolescents 2 to 17 years

It should be applied to the infected skin and surrounding areas twice daily.

Tinea versicolor.

Adults

It should be applied to the infected skin and surrounding areas twice daily.

Children and Adolescents

It should be applied to the infected skin and surrounding areas twice daily.

Side effects

Some common side effects of Terbinafine are

If you use a cream, gel, spray, or solution, talk to your pharmacist or doctor if you observe t:

  • Peeling or itching skin

Inform your doctor if you face these side effects:

  • Rash
  • Headache
  • Diarrhea
  • Feeling or being sick (nausea or vomiting)
  • Smaller appetite than usual
  • Stomach ache
  • Indigestion
  • Muscle or joint pain

Common side effects of Clotrimazole are;

  • Red, irritated skin
  • Burning skin or pain

If the side effects bother you for long, start using a smaller amount of treatment or consult your doctor.

Some severe side effects of both Terbinafine and Clotrimazole are;

  • Skin rashes and itchiness
  • Difficulty in breathing
  • swelling of lips and throat

Health Conditions

Terbinafine under condition

       1. Alcohol

Yes, you can drink alcohol while taking terbinafine

  1. In Liver disease

In patients with chronic or active liver disease, oral terbinafine is not indicated. Terbinafine has the potential to be hepatotoxic.

  1. Neutropenia

Isolated cases of severe neutropenia were reported in some patients who consumed oral terbinafine. Although neutropenia resolved after discontinuation of terbinafine with or without adjuvant therapy, no causal link was established.

  1. Depression

People suffering from depression should take this medicine with caution keeping the symptoms in mind. Patients and caregivers should inform patients and caregivers of any symptoms of depression.

  1. Immunosuppression

Full blood count monitoring is required in those taking terbinafine for more than six weeks and with known or suspected immunosuppression.

  1. Lupus

Terbinafine should not be used by patients suffering from symptoms like lupus erythematosus.

Clotrimazole under condition

  1. Budesonide / formoterol

Clotrimazole may help the drug budesonide be absorbed into the bloodstream. Weight gain, high blood pressure, swelling, high blood sugar, muscle weakness, depression, acne, thinning skin, stretch marks, easy bruising, loss of bone density, cataracts, irregular periods, excessive hair growth on face and body and uneven fat distribution are all possible side effects.

  1. Hepatic Dysfunction

When using clotrimazole lozenges, abnormal liver function tests have been reported, most of the SGOT values are usually slightly increased. Patients with pre-existing liver failure should have their liver function tested regularly.

Warnings

Terbinafine

Adults and children one year of age and older may be prescribed tablets, creams, and gels. (Balfour, J.A)

Creams, gels, and sprays available in pharmacies and supermarkets are suitable for people 16 years of age and older. Only adults 18 years and older should use solutions.

Inform your doctor or pharmacist, If

  • Kidney and liver disorders
  • Are pregnant, trying to conceive or breast-feeding
  • Have ever had an adverse reaction to terbinafine or any other medicine.

Clotrimazole

Most adults and children can use clotrimazole cream, spray, or solution.

Clotrimazole is not a medicine that should be used by everyone. If you have ever had an allergic reaction to clotrimazole or any other medication, consult your doctor to know the safety of the medicine.(Bodey, G.P., 1972)

Which Is More Effective

A study was conducted to observe the efficacy and safety of terbinafine 1% cream and clotrimazole 1% cream for tinea pedis treatment.

A multicentre, double-blind, parallel-group has taken evaluable 211 patients. 107 with a mean age of 40 were randomized with terbinafine, and the remaining 104 with a mean age of 36 with clotrimazole.

Inert cream was applied two times a day daily for 3 weeks while Terbinafine was used twice a day for a span of 2 weeks. Clotrimazole 1% cream applied daily for four weeks. Mycological cure and effective treatment were measured at 1,2,3,4,5, and 6 weeks.

The results show that a one-week course of 1% terbinafine cream is more effective than a four-week course of 1% clotrimazole cream in treating tinea pedis both in terms of mycological cure effective treatment of the disease.

Difference between Terbinafine and Clotrimazole:

Particular

Terbinafine

Clotrimazole

Antifungal

Used as antifungal

Used as an antifungal. It is used in the treatment of vaginal yeast infections, oral thrush, tinea versicolor, or tinea corporis.

Over the Counter/ Prescription

 over-the-counter (OTC) and as a generic

 over-the-counter (OTC) and as a generic

Side effects

Similar side effects that include itching and hives

Similar side effects that include itching and hives

Uncommon Side effects

Side effects different from Clotrimazole are diarrhea, cough, abdominal pain, abdominal pain, and headache.

Side effects different from terbinafine are local redness, stinging, blistering, peeling, swelling, or burning at the area of application, and nausea and vomiting.

Conclusion

Terbinafine is more effective than Clotrimazole. One should always consult the doctor and talk about the medical history to prevent from negative effects before taking any medicine.

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