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 a first-choice treatment option for fingernail and toenail fungus. It's available as once-daily tablets, but treatment can take many weeks. Common side effects of terbinafine include headache, rash, diarrhea, and upset stomach. Terbinafine can have interactions with other medications, including certain antidepressants, beta-blockers, and some medications that treat an irregular heart rhythm.
What is Terbinafine?
What is Terbinafine used for?
- Fungal infection of toenail or fingernail
How Terbinafine works
Terbinafine is an antifungal. It kills the fungus causing the infection by preventing it from forming its protective outer layer.
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%)
- Upset stomach (4%)
Less Common Side Effects
- Changes in your sense of taste
- Nausea
- Stomach pain
- Excessive gas
- Itching
- Hives
- Changes in vision
- Changes to liver blood test results
Terbinafine serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Liver damage: nausea, vomiting, right upper stomach pain, dark urine, pale stools, yellowing of the skin or whites of the eyes
- Serious allergic reaction: rash, blisters, fever, flu-like symptoms
When do Terbinafine possible side effects begin and end?
Time passed since treatment started:
H
D
W
M
Changes in taste
Diarrhea
Stomach upset
Rash
Headache
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
$24.72
GoodRx discount
$14.00
Pros and cons of Terbinafine
Pros
- Works better to treat nail fungus than other treatment options
- First-choice over other antifungal medications that are taken by mouth (e.g., versus itraconazole (Sporanox))
- Only taken once a day, with or without food
- Lower-cost generic available
Cons
- Can take several weeks to work
- Can cause loss of taste or smell (sometimes permanently)
- Not recommended if you have long-term or current liver problems
- Not studied in children
Pharmacist tips for Terbinafine
- You can take terbinafine with or without food. If you experience upset stomach or nausea from terbinafine, taking it with food can help lessen these side effects.
- If you forget to take your dose of terbinafine, take it as soon as you remember. But if it's fewer than 4 hours before your next dose is due, skip the missed dose and continue with your usual dosing schedule.
- Terbinafine tablets can affect your sense of taste or smell. If you notice any changes to these senses at any time while taking terbinafine tablets, contact your healthcare provider. You might need to take a different medication.
- Before going out into the sun, wear protective clothing and sunscreen. Terbinafine can make your skin more sensitive to sunlight, which might make it easier to get sunburns or a rash.
- Your nail(s) can take several months to look normal again after using terbinafine. Sometimes, your nail(s) might not look completely better even after you finish your last dose of terbinafine. This doesn't mean that the medication didn't work.
- If you have any concerns that your infection isn't better after finishing your course of terbinafine, contact your healthcare provider.
- Before starting any new medications, check with your pharmacist or provider first. They can make sure your medications are safe to take. Terbinafine can interact with some medications that you might be taking at the same time. Terbinafine can also stay in your system for months after you stop taking it and interact with other medications even after you've finished your antifungal treatment.
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 severe liver damage or even liver failure, which can be life-threatening. Your risk of liver injury is higher if you have or have had liver problems. You'll have to get blood tests done before you start terbinafine and during treatment. These test results help your provider make sure your liver stays healthy. If you experience unexplained stomach pain, nausea, vomiting, dark urine, pale stools, or yellowing of your skin or white part of your eyes, contact your healthcare provider right away.
Changes to taste and smell
Sometimes, people taking terbinafine can experience changes in their senses of taste and smell. Most times, your sense of taste can come back as you continue to take the medication. But although rare, it's possible that these side effects might go away a few weeks after the medication is stopped, linger on for much longer, or become permanent loss of smell or taste. Talk to your healthcare provider if this happens to you because you might need to stop taking terbinafine.
Depression
Some people noticed that their mood went down while they were taking terbinafine. Talk to your healthcare provider if you notice any unusual changes in sleep, mood, or develop symptoms of depression.
Low white blood cell levels
- Risk factors: Currently have a weak immune system | Taking terbinafine longer than 6 weeks
Terbinafine can lower the number of white blood cells in your body. White blood cells help fight off infections. Without a healthy amount of white blood cells, you can get sick easier and have a harder time getting better once you're sick. This side effect is rare, but it can be life-threatening. You're at risk of having low white blood cells if you already have a weak immune system and are taking terbinafine for longer than 6 weeks. You might have to get blood tests done regularly while you're taking terbinafine to make sure your white blood cells are at a normal level. If your levels drop too low, you'll probably have to stop taking terbinafine.
Serious skin reactions
Very rarely, people have developed severe, potentially life-threatening skin reactions after starting terbinafine. These types of allergic rashes are painful and create blisters all over the body. Get medical attention right away if you notice a new or severe rash, a rash that happens with a fever, unexplained blisters, flu-like symptoms, or new sores inside your mouth.
Lupus flare up
- Risk factors: History of lupus
Terbinafine might cause a flare-up of lupus. This is rare. But if it happens, you might have to stop taking terbinafine tablets and use a different medication. Let your healthcare provider know if you have or have had lupus before starting terbinafine so they can keep an eye out for signs of a flare up.
Clotting and bleeding problems
In some rare cases, terbinafine tablets might affect your body's ability to form blood clots. This can be life-threatening. If you experience unusual fever, weakness, bruises, purple dots on the skin, or unusual bleeding (bleeding of the gums, nose bleed, or heavy bleeding from a minor cut), get medical help right away.
Terbinafine dosage
The average cost for 30 tablets of 250mg of Terbinafine is $14.00 with a free GoodRx coupon. This is 43.37% off the average retail price of $24.72. 
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 6 weeks (for fingernail infection) or 12 weeks (for toenail infection).
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
