What Are the Best Treatments for Toenail Fungus (Onychomycosis), and How Does It Look?
There are a variety of treatments for toenail fungus, from prescription pills to OTC creams. Experts discuss which toenail fungus treatments are most effective.
terbinafine
Used for Nail Fungus
Used for Nail Fungus
Terbinafine is used to treat fingernail and toenail fungus in adults. It's a type of antifungal that helps get rid of the fungus. Terbinafine is a tablet you take once a day, but treatment can take many weeks to finish. Common side effects include headache, rash, and diarrhea. Terbinafine can interact with other medications, including certain antidepressants and beta blockers.
What is Terbinafine?
What is Terbinafine used for?
How Terbinafine works
Terbinafine is a type of antifungal. It prevents fungus from forming its protective outer layer. This kills the fungus causing the infection.
When does Terbinafine start working?Time passed since treatment started:
Drug facts
| Common Brands | Lamisil |
|---|---|
| Drug Class | Antifungal |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Terbinafine essentials
Side effects of Terbinafine
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (13%)
- Rash (6%)
- Diarrhea (6%)
- Indigestion (4%)
Less Common Side Effects
- Changes in your sense of taste
- Nausea
- Stomach pain
- Feeling gassy
- Itching
- Hives
- Changes in vision
- Changes to liver enzyme levels
Terbinafine serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Liver damage: nausea, vomiting, pain in the upper right side of your stomach, dark urine, pale stools, yellowing of your skin or whites of your eyes
- Lupus-like symptoms: painful and swollen joints, rash, sores in the mouth or nose
- Symptoms of depression
- Serious skin reaction or allergic reaction: rash, blisters, fever, peeling skin, flu-like symptoms, trouble breathing, swelling of the face or throat, swelling of the lips or tongue
When do Terbinafine possible side effects begin and end?
Time passed since treatment started:
H
D
W
M
Diarrhea
Stomach upset
Rash
Changes in taste
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.
More on Terbinafine side effects
The following Terbinafine side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Less common
Body aches or pain
chills
difficulty with breathing
ear congestion
general feeling of discomfort or illness
headache
joint pain
loss of appetite
loss of voice
shivering
skin rash or itching
sweating
trouble with sleeping
unusual tiredness or weakness
upper abdominal or stomach pain
vomiting
Rare
Dark urine
difficulty with swallowing
pale skin
pale stools
redness, blistering, peeling, or loosening of the skin
stomach pain
unusual bleeding or bruising
yellow skin or eyes
Incidence not known
Black, tarry stools
bleeding gums
blood in the urine or stools
cough or hoarseness
dizziness
fast heartbeat
feeling of discomfort
flu-like symptoms
general feeling of tiredness or weakness
high fever
indigestion
inflammation of the joints
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
light-colored stools
lower back or side pain
muscle aches
painful or difficult urination
pains in the stomach, side, or abdomen, possibly radiating to the back
persistent loss of appetite
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
red, scaling, or crusted skin
sores, ulcers, or white spots on the lips or in the mouth
sores, welting, or blisters
stomach pain, continuing
swollen glands
swollen lymph glands
tightness in the chest
troubled breathing with exertion
ulcers, sores, or white spots in the mouth
unexplained bleeding or bruising
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Stomach pain (mild)
Less common
Acid or sour stomach
bad, unusual, or unpleasant (after) taste
belching
change of taste or loss of taste
toothache
Incidence not known
Decreased vision
difficulty with moving
discouragement
feeling sad or empty
irritability
lack of appetite
loss of interest or pleasure
loss of sense of smell
muscle cramps or spasms
muscle stiffness
tiredness
trouble concentrating
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
$24.73
GoodRx discount
$14.00
Pros and cons of Terbinafine
Pros
- Works better to treat nail fungus than other treatment options
- First-choice over other antifungals that are taken by mouth
- Taken once a day, with or without food
Cons
- Can take several weeks to work
- Can cause loss of taste or smell (sometimes permanently)
- Not recommended if you have liver problems
Pharmacist tips for Terbinafine
- You can take terbinafine with or without food. If you have upset stomach or nausea from the medication, taking it with food can help lessen these side effects.
- If you forget to take your terbinafine dose, take it as soon as you remember. But if there's less than 4 hours left until your next dose, skip the missed dose and take your usual dose the next day. Then, continue with your usual dosing schedule.
- It can take several months for your nail(s) to look normal again after taking terbinafine. Sometimes, they might not look completely better even after you finish your treatment course. But this doesn't mean that it didn't work. If you think your infection isn't better after treatment, talk to your prescriber.
- Terbinafine tablets can affect your sense of taste or smell. If you notice any changes to these senses at any time while taking this medication, let your care team know. You might need to stop terbinafine and switch to a different medication.
- Try to drink less caffeine or avoid it while taking terbinafine. The medication can raise the caffeine levels in your body. This can make you feel more jittery from the caffeine.
- It's best to avoid alcohol while taking terbinafine. This medication has been linked to rare cases of liver injury. And drinking a lot of alcohol can also damage your liver. Talk to your prescriber about how much you usually drink and how to take this medication safely.
- Before going out into the sun, wear protective clothing and sunscreen. Terbinafine can sometimes make your skin more sensitive to sunlight. This might make it easier to get sunburns or a rash.
- Before starting any new medications, check with your pharmacist or prescriber. They can make sure your medications are safe to take together. Terbinafine can interact with some medications and raise your risk of side effects. These can include some antidepressants, beta blockers, and Parkinson's medications.
- If you're pregnant or thinking of becoming pregnant: Speak to your prescriber about the risks and benefits of taking terbinafine. It's not clear if this medication is safe during pregnancy. Your prescriber can help you choose a safe treatment option.
- If you're breastfeeding: Tell your prescriber. Terbinafine can pass into breast milk. But there isn't enough information to know how it could affect your baby or your milk supply. Your prescriber can discuss the risks and benefits with you. They can provide guidance about safe feeding options.
Risks and warnings for Terbinafine
Terbinafine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Liver damage
- Risk factors: History of liver problems | Current liver problems
Very rarely, terbinafine can cause serious liver damage or even liver failure. This can be life-threatening. The risk of liver injury is higher if you have or had liver problems.
Before starting terbinafine, tell your prescriber if you have liver problems. You'll also need blood tests done so your prescriber can check your liver. Both helps your prescriber decide if this medication is safe for you.
While taking terbinafine, you'll keep getting blood tests to check your liver. Also watch for signs of liver problems. This includes long-lasting nausea, vomiting, stomach pain, dark urine, pale stools, or yellowing of your skin or whites of your eyes. If this happens, tell your care team right away. If liver damage happens, you'll need to stop taking terbinafine.
Changes to taste or smell
Some people taking terbinafine tablets can have changes in taste or smell. This can sometimes include a loss of these senses. In particular, changes in taste can sometimes be severe, lower your appetite, and be worrisome.
Most times, changes in taste or smell go away with time after you stop taking terbinafine. It can last a few weeks after you stop. But it can sometimes linger much longer or even become permanent.
Tell your prescriber if you notice a change or loss in taste or smell while taking terbinafine. You might need to stop taking the medication.
Symptoms of depression
Some people noticed that their mood went down while they were taking terbinafine. Talk to your prescriber if you notice any unusual changes in your sleep or mood or symptoms of depression.
Low white blood cell counts
- Risk factors: Currently have a weak immune system | Taking terbinafine longer than 6 weeks
It's not common, but terbinafine can temporarily lower your white blood cell count. Although rare, it can get dangerously low. White blood cells help fight off infections. If your white blood cell count is low, you can get sick more easily and have a harder time getting better from infections.
Tell your prescriber about your full medical history. You're at risk of having low white blood cell counts if you already have a weak immune system. If you're at risk, your prescriber might check your blood counts regularly if you need to take terbinafine for longer than 6 weeks. If your levels drop too low, you'll probably have to stop taking the medication to help your levels get back up.
Be aware of signs of infection while taking terbinafine. This can include a fever, chills, body aches, cough, sore throat, or pain while urinating. If this happens, get urgent care to get checked out.
Serious skin reactions
Very rarely, terbinafine can cause serious skin reactions that can be life-threatening. These allergic rashes can be painful and cause blisters all over the body. Get medical help right away if you notice a new or severe rash, a rash with a fever, blisters, peeling skin, sores inside your mouth, or flu-like symptoms. These can be signs of a serious reaction to the medication.
Lupus flare up
- Risk factors: History of lupus
It's rare, but terbinafine tablets might cause a flare-up of lupus. If this happens, you might have to stop taking this medication.
Let your prescriber know if you have or have had lupus so they can keep an eye out for signs of a flare up. It's also a good idea for you to look out for signs as well. This includes painful and swollen joints, rash, or sores in the mouth or nose. Tell your care team if you notice this while taking terbinafine.
Clotting and bleeding problems
In rare cases, terbinafine tablets can cause certain serious blood problems. It can affect how your blood clots and lower your red blood cells and platelets. This can be life-threatening.
Get medical help right away if you notice possible signs of these serious blood problems. This can include fever, weakness, or shortness of breath. It can also include easy bruising, purple dots on the skin, or unusual bleeding (e.g., gum bleeding, frequent nosebleeds, heavy bleeding from a small cut).
Terbinafine dosage
The average cost for 30 tablets of 250mg of Terbinafine is $14.00 with a free GoodRx coupon. This is 43.39% off the average retail price of $24.73. 
Tablet
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 250mg | 30 tablets | $14.00 | $0.47 |
Typical dosage for Terbinafine
The typical dose is 250 mg by mouth once a day.
- For fingernail infection: It's taken daily for 6 weeks.
- For toenail infection: It's taken daily for 12 weeks.
More on Terbinafine dosage
Interactions between Terbinafine and other drugs
Terbinafine may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Terbinafine. Please note that only the generic name of each medication is listed below.
More on Terbinafine interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Eliglustat
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amphetamine
- Aripiprazole
- Benzphetamine
- Brexpiprazole
- Clozapine
- Codeine
- Deutetrabenazine
- Dextroamphetamine
- Dihydrocodeine
- Donepezil
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Fluoxetine
- Lisdexamfetamine
- Methamphetamine
- Metoclopramide
- Metoprolol
- Nebivolol
- Pitolisant
- Risperidone
- Tramadol
- Valbenazine
- Vortioxetine
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Terbinafine cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Terbinafine (generic)
$14.00
Terbinafine contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Terbinafine will not be safe for you to take.
- Long-term or active liver problems
What are alternatives to Terbinafine?
There are a number of medications that your doctor can prescribe in place of Terbinafine. Compare a few possible alternatives below.
Used for:
Severe fungal infections in people with weakened or healthy immune systems - itraconazole (Tolsura) and itraconazole (Sporanox) capsule:
Fungal toenail and fingernail infections (onychomycosis) for people with healthy immune systems - itraconazole (Sporanox) capsule only
$47.41View prices
News about Terbinafine
Caffeine, Alcohol, and More: 7 Terbinafine Interactions to Be Aware Of
Read on for common food and drug interactions to know about when taking terbinafine (Lamisil) and when to reach out to a healthcare professional.
Tinea Versicolor Treatment: Antifungal Medications and Natural Remedies
Tinea versicolor is a condition that changes the color of your skin. You can get rid of tinea versicolor with different medications.
What Is Scalp Ringworm (Tinea Capitis)? Common Causes, Symptoms, and Treatment
Scalp ringworm (tinea capitis) is a fungal infection of the scalp. Learn how it spreads and how to prevent it.
3 Athlete’s Foot Treatments You Have to Try for Long-Lasting Relief
Athlete’s foot (tinea pedis) is a common fungal infection that can cause itchy feet. See images of athlete’s foot and learn about OTC creams and home remedies.
Fluconazole, Terbinafine, and More: 8 Oral Antifungal Medications and How They Differ
Oral antifungal medications, such as Lamisil and Diflucan, help treat or prevent certain fungal infections. Learn about eight different prescription options and how they differ.
What Causes Athlete’s Foot (Tinea Pedis), and What Does It Look Like?
Athlete’s foot (tinea pedis) is a fungal infection of the foot that can cause itching, peeling, and burning. See pictures of athlete’s foot and learn how to treat it.
Ringworm in Dogs: Everything You Need to Know, From a Veterinarian
Ringworm in dogs causes circular-shaped hair loss and crusty patches on a dog’s skin. Learn how to treat ringworm in dogs and what you should know about it.
Ringworm in Cats: What It Looks Like and How You Treat It
Ringworm is a skin infection that can affect cats, humans, and other animals. Learn about the signs and symptoms of ringworm in cats, plus treatment options.
How Long Does It Take for Lamisil to Work? Plus, 4 More FAQs
Lamisil is an antifungal medicine that’s available as a cream and an oral tablet. See how long each form takes to work, plus answers to other Lamisil questions.
Terbinafine images
