테르비나핀
Terbinafine
Terbinafine Hydrochloride
다른 이름: Lamisil · Terbinex · Alamil · Daskil · Daskyl · DesenexMax · Finex · Maditez · Micosil · Terekol · Osurnia · Terbinafine hydrochloride · Terbinafinum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Dermatophytic infections | 10-20 mg/kg | PO | q24h | — | 🌎 NA |
| Dermatophytic infections (when other drugs are not tolerated) | 25 mg/kg | PO | q24h | — | 🌎 NA |
| Adjunctive treatment of nasal Aspergillus infections (if cribriform plate is penetrated) | 5-10 mg/kg | PO | q12h | 3-6 months | 🌎 NA |
| Pythiosis (where advanced disease precludes complete surgical excision) | 10 mg/kg | PO | q24h | — | 🌎 NA |
| Lagendiosis (where disease precludes complete surgical excision) | 5-10 mg/kg | PO | q24h | — | 🌎 NA |
| Antifungal (Systemic/Dermatophytosis) | 20-40 mg/kg | PO | q24h | Not specified | 🌍 EU |
| Localized Malassezia infections | Apply a thin layer | topical | Not specified | Not specified | 🌍 EU |
| Acute otitis externa (S. pseudintermedius, M. pachydermatis) | 1 tube per infected ear | topical | Repeat after 7 days | 2 doses total | 🌍 EU |
- Dermatophytic infections: Appears to be better tolerated than either ketoconazole or itraconazole.
- Adjunctive treatment of nasal Aspergillus infections (if cribriform plate is penetrated): Used with topical therapy.
- Pythiosis (where advanced disease precludes complete surgical excision): Given concurrently with itraconazole (10 mg/kg PO twice daily).
- Lagendiosis (where disease precludes complete surgical excision): Given concurrently with itraconazole (10 mg/kg PO q24h) and repeated aggressive surgical resection.
- Antifungal (Systemic/Dermatophytosis): Doses greater than 30 mg/kg may be required to reach therapeutic levels in the skin of dogs.
- Localized Malassezia infections: Use 1% cream.
- Acute otitis externa (S. pseudintermedius, M. pachydermatis): Ear gel should be instilled in a cleaned ear. Maximum clinical response may not be seen until 21 days after the second administration.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Dermatophytic infections (Pulse therapy) | 20 mg/kg | PO | q24h | 7 days on, then 21 days off | 🌎 NA |
| Dermatophytic infections | 10-20 mg/kg | PO | q24h | — | 🌎 NA |
| Dermatophytic infections (when other drugs are not tolerated) | 25 mg/kg | PO | q24h | — | 🌎 NA |
| Dermatophyte (M. canis) mycetomas | 26-31 mg/kg | PO | q24h | 12-14 weeks | 🌎 NA |
| Cryptococcal infections (azole-resistant) | 10 mg/kg | PO | q24h | Life-long | 🌎 NA |
| Antifungal (Systemic/Dermatophytosis) | 20-40 mg/kg | PO | q24h | Not specified | 🌍 EU |
| Localized Malassezia infections | Apply a thin layer | topical | Not specified | Not specified | 🌍 EU |
- Dermatophytic infections (Pulse therapy): Maintained terbinafine concentrations in hair above therapeutic levels. Higher doses (40 mg/kg) or continuous administration caused emesis and elevated hepatic enzymes.
- Dermatophytic infections: Appears to be better tolerated than either ketoconazole or itraconazole.
- Dermatophyte (M. canis) mycetomas: Achieved clinical and mycological cure in a case report of two cats.
- Cryptococcal infections (azole-resistant): Can rectify clinical signs, though cats with CNS cryptococcus usually require treatment for life.
- Localized Malassezia infections: Use 1% cream.
새
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Avian mycotic infections (Aspergillus) | 10-15 mg/kg | PO | q12-24h | — | 🌎 NA |
| Avian mycotic infections (Aspergillus) | 1 mg/mL aqueous solution | Nebulization | Not specified | — | 🌎 NA |
| Avian mycotic infections | 10-15 mg/kg | PO | q12-24h | — | 🌎 NA |
| Avian mycotic infections | 1 mg/mL | Nebulization | Not specified | — | 🌎 NA |
| Aspergillosis (suspected via leukocytosis and pulmonary nodules) | 10-15 mg/kg | PO | q12h | 4 weeks | 🌎 NA |
- Avian mycotic infections (Aspergillus): Appears to be well tolerated by a number of avian species.
- Avian mycotic infections: Suspend a 250 mg tablet in 25 mL water. Can be used in combination with itraconazole.
- Avian mycotic infections: Mix 500 mg terbinafine plus 1 mL Mucomyst plus 500 mL of distilled water.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
테르비나핀은 경구 및 국소 제제로 제공되는 합성 알릴아민계 항진균제입니다.
주요 임상 특징:
- 주요 용도: 개와 고양이의 피부사상균 감염(예: 소포자균, 백선균)에 매우 효과적입니다. 또한 조류의 전신성 진균 감염(예: 아스페르길루스증) 치료에도 사용됩니다.
- 우수한 상호작용 프로파일: 아졸계 항진균제(예: 케토코나졸, 이트라코나졸)와 달리 테르비나핀의 주요 작용 기전은 시토크롬 P-450 효소계에 의존하지 않으므로 약물 상호작용이 현저히 적고 포유류의 테스토스테론이나 코르티솔 합성을 억제하지 않습니다.
- 약리학적 특징: 테르비나핀은 지용성이 높고 친각질성(keratinophilic)을 띱니다. 피부, 피지, 모낭에 광범위하게 분포하며, 치료를 중단한 후에도 수주 동안 이들 조직에서 치료 농도를 유지합니다(이로 인해 펄스 요법이 가능함).
- 내약성: 수의학 환자에서 일반적으로 내약성이 매우 우수하며, 가장 흔하게 보고되는 부작용은 가벼운 위장관 장애(구토)입니다.
작용 기전
Terbinafine exerts its antifungal activity by interfering with fungal sterol biosynthesis at an early stage.
- It selectively and reversibly inhibits the fungal enzyme squalene monooxygenase (also known as squalene 2,3-epoxidase).
- This blockade prevents the conversion of squalene to lanosterol → leading to a profound deficiency of ergosterol (a critical component of the fungal cell membrane).
- Simultaneously, the inhibition causes an intracellular accumulation of squalene, which is directly toxic to the fungal cell, leading to rapid cell death.
This dual mechanism makes terbinafine primarily fungicidal against dermatophytes, though it may only be fungistatic against certain yeasts like Candida spp.
안전성·주의사항
금기사항
- Known hypersensitivity to terbinafine
- Active or chronic liver disease
- Significantly impaired renal function
- Perforated eardrum (for ear gel administration)
- Generalized demodicosis (topical or systemic use)
- Pregnant animals
- Breeding animals
부작용
- Vomiting
- Inappetence
- Diarrhea
- Lethargy (reported in cats)
- Hepatotoxicity / Liver failure (very rare, reported in humans)
- Neutropenia (very rare, reported in humans)
- Serious skin reactions like Toxic Epidermal Necrolysis or Stevens-Johnson syndrome (very rare, reported in humans)
- Diarrhoea
- Increased liver enzymes
- Pruritus (cats)
- Topical irritation (due to alcohol content in topical solutions)
- Transient deafness or impaired hearing (in elderly dogs after administration of ear gel)
주의
Hepatic and Renal Warning: Use with extreme caution, if at all, in patients with markedly impaired liver or renal function. Dosage adjustments should be considered if use is unavoidable.
- Pregnancy/Nursing: Definitive safety in pregnancy has not been established (FDA Category B in humans). The manufacturer recommends against use in pregnant or nursing individuals, as the drug concentrates in maternal milk at levels 7 times higher than plasma. Use with caution in nursing veterinary patients.
약물 상호작용
Terbinafine may increase the elimination and decrease the efficacy of cyclosporine.
May increase terbinafine clearance, potentially requiring higher terbinafine doses.
Terbinafine shares the CYP2D6 metabolic pathway and could theoretically alter the metabolism of beta-blockers.
Terbinafine shares the CYP2D6 metabolic pathway and could theoretically alter the metabolism of MAOIs.
Terbinafine shares the CYP2D6 metabolic pathway and could theoretically alter the metabolism of SSRIs.
Terbinafine shares the CYP2D6 metabolic pathway and could theoretically alter the metabolism of TCAs.
May decrease the clearance of terbinafine, potentially increasing plasma concentrations (Clinical Pearl)
모니터링
- Clinical efficacy (resolution of fungal lesions)
- Baseline liver enzymes prior to therapy
- Periodic liver enzyme monitoring as needed, especially during long-term treatment
- CBC (baseline and periodic)
- Liver function tests (ALT, AST, Bilirubin)
- Renal function tests
- Clinical response (skin scrapings, fungal cultures)
약동학
반감기
흡수
In humans, oral absorption is >70%, but first-pass metabolism reduces bioavailability to about 40%. Food may slightly enhance absorption.
분포
Highly lipophilic and keratinophilic. Distributes extensively into the skin, sebum, and adipose tissue, where it can persist for very long periods. >99% bound to plasma proteins.
대사
Metabolized in the liver.
배설
Eliminated primarily after hepatic metabolism.
과다투여
There is limited information regarding acute toxicity in veterinary species. In humans, acute ingestions of up to 5 grams have been reported without serious adverse effects. Treatment of massive overdose should be supportive and symptomatic.
제품
제형
- Oral granules
- Aqueous solution (for nebulization)
- 250 mg oral tablets
- 1% topical cream
- 1% topical gel
- 1% topical spray
- 10 mg ear gel (combination product containing terbinafine, florfenicol, and betamethasone)
동물용의약품
- Osurnia ear gel (10 mg terbinafine, florfenicol, betamethasone)
인용의약품
- Terbinafine HCl Oral Tablets: 250 mg (Lamisil, Terbinex, generic)
- Terbinafine HCl Oral Granules (film-coated): 125 mg/packet & 187.5 mg/packet (Lamisil)
- Topical cream 1%
- Topical spray 1%
- Lamisil 250 mg tablets
- Lamisil 1% cream
- Lamisil 1% gel
- Lamisil 1% spray
규제 현황
POM-V
POM-V, POM
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store tablets at room temperature in tight containers; protect from light.
보호자 정보
반려동물 보호자를 위한 중요 정보
- 투여 방법: 이 약은 음식과 함께 투여하는 것을 강력히 권장합니다. 이는 흡수를 돕고 위장 장애나 구토의 가능성을 크게 줄여줍니다.
- 치료 기간: 진균 감염(예: 링웜)이 낫는 데는 시간이 걸립니다. 수주에서 수개월 동안 약을 먹여야 할 수도 있습니다. 수의사의 지시가 없는 한, 반려동물의 상태가 좋아진 것 같아도 일찍 투약을 중단하지 마십시오.
- 주의 깊게 관찰할 사항: 테르비나핀은 일반적으로 매우 안전합니다. 그러나 반려동물에게 지속적인 구토, 식욕 부진, 심한 설사 또는 극심한 피로가 나타나면 수의사에게 연락하십시오.
- 드물지만 심각한 증상: 매우 드물게 이 약이 간에 영향을 미칠 수 있습니다. 눈, 잇몸 또는 피부가 노랗게 변하는 것(황달)을 발견하면 즉시 수의사에게 연락하십시오.
- 비용: 전체 치료 과정에 상당한 비용이 들 수 있으나, 제네릭(복제약) 옵션이 있어 이전보다 저렴하게 이용할 수 있습니다.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.