The authority listing for terbinafine 250 mg tablets was extended on 1 April 2008 to allow the treatment of Aboriginal and Torres Strait Islander peoples with a dermatophyte infection that has not responded to topical treatment. Effective 1 July 2008, there will also be a new streamlined authority
listing for terbinafine 1% cream, allowing for the treatment of fungal or yeast infections in Aboriginal and Torres Strait Islander peoples.
1
Oral terbinafine is associated with rare but serious adverse effects (e.g. blood dyscrasias, liver failure).2-5 Prescribe the tablets only after the cream, if this has not treated the fungal infection. Monitor
blood count and liver enzymes if more than 6 weeks of treatment is required.
6
Terbinafine inhibits cytochrome P450 2D6 in the liver and may increase the risk of adverse effects of coadministered drugs that are metabolised by this enzyme (e.g. selective
serotonin reuptake inhibitors). The potential for drug interactions may last for months after stopping oral terbinafine (treatment itself can last for up to 6 months) because of its very long half life (about 36 hours).
2,6
The PBAC recommended the listing
of these terbinafine preparations under the 2004-05 Budget measure that allows PBS listing of medicines specifically for Aboriginal and Torres Strait Islander peoples. For more information, refer to the NPS RADAR In Brief '
Medicines listed on the PBS for Indigenous Australians'
or the
Department of Health and Ageing website.
