Thermikon - instructions for use, reviews, analogs and forms of release (tablets of 250 mg, cream or ointment 1%, spray 1%) of the drug for the treatment of nail fungus and skin, multi-colored hair loss in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Thermicon. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Termicon in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Thermicon with available structural analogues. Use for the treatment of nail fungus and skin, multicolored lichen in adults,children, as well as during pregnancy and lactation. Composition of the drug based on terbinafine.

Thermicon - antifungal drug, allylamine. Has a wide range of antifungal action.

It is active against dermatophytes: Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, Trichophyton verrucosum, Trichophyton violaceum, Microsporum canis, Epidermophyton floccosum. At low concentrations, it has a fungicidal effect on dermatophytes, mold fungi (including Aspergillus, Cladosporium, Scopulariopsis brevicaulis) and some dimorphic fungi. On yeast fungi of the genus Candida (Candida) (mainly Candida albicans) and their filamentous forms, depending on the species, the preparation has a fungicidal or fungistatic effect.

The thermocouple breaks the early stage of biosynthesis of the main component of the cell membrane of the ergosterol fungus by inhibiting the squalene epoxidase enzyme. This leads to a deficit of ergosterol and to intracellular accumulation of squalene, which causes death of the fungal cell. The action of Terbinafine is carried out by inhibiting the enzyme squalene epoxidase located on the cell membrane of the fungus.

When ingestion is not effective in the treatment of varicolored lichen, caused by Pityrosporum orbiculare (Malassezia furfur).

Composition

Terbinafine hydrochloride + excipients.

Pharmacokinetics

After ingestion, the drug is well absorbed from the digestive tract.After 0.8 h, half of the dose taken is absorbed. Eating does not affect the bioavailability of terbinafine. Binding to blood plasma proteins - 99%. After 4.6 hours after administration, half of the dose taken is distributed in the body. The drug quickly penetrates the dermal layer of the skin and nail plates. Penetrates into the secretion of sebaceous glands, accumulates in high concentrations in the hair follicles, in hair, skin and subcutaneous tissue. Do not cum in the body. Terbinafine is excreted in breast milk. Biotransformiruetsya in the liver with the formation of inactive metabolites. In the form of metabolites with urine, about 80% of the dose taken, the rest - with feces (22%).

The age of the patients does not affect the pharmacokinetics of terbinafine, however, excretion of the drug may decrease with kidney or liver damage, leading to high concentrations of terbinafine in the blood.

Indications

• mycoses of the scalp (trichophytosis, microsporia);
• mycosis of the skin and nails, caused by Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, Trichophyton verrucosum, Trichophyton violaceum, Microsporum canis, Microsporum gypseum and Epidermophyton floccosum;
• onychomycosis;
• severe common dermatomycosis of the smooth skin of the trunk and extremities requiring systemic treatment;
• candidiasis skin and mucous membranes.

Forms of release

Tablets 250 mg.

Cream for external use 1% (sometimes mistakenly called ointment).

Spray for external use 1%.

Instructions for use and treatment regimen

Pills

The duration of the course of treatment and the dosage regimen is determined individually and depends on the localization of the process and the severity of the disease.

Inside adults, the drug is prescribed 250 mg once a day (after meals).

With onychomycosis, the duration of treatment is about 6-12 weeks. With onychomycosis of the hands and feet (except for the big toe), or in young patients, the duration of treatment may be less than 12 weeks. When infection of the thumb of the foot is usually enough treatment course at 3 months. In rare cases, slower growth of nails may require longer treatment - up to 6 months or more.

With dermatomycosis of the foot (interdigital, plantar or as a socks), the duration of treatment is 2 to 6 weeks; with shin dermatomymosis - from 2 to 4 weeks; with torso dermatomycosis - 4 weeks; with candidiasis of the skin and mucous membranes from 2 to 4 weeks.

With mycosis of the scalp caused by Microsporum canis, the recommended duration of treatment is more than 4 weeks.

Children with a body weight of 20 to 40 kg of the drug is prescribed in a dose of 125 mg (1/2 tablets) once a day, with a body weight of more than 40 mg - 250 mg once a day. The duration of mycosis treatment of the scalp is about 4 weeks. In cases where the pathogen is Microsporum canis, the treatment may be longer.

Older patients are prescribed the drug in the same doses as adults.

If renal insufficiency is severe (KK less than 50 ml / min or serum creatinine content is more than 300 μmol / l), if the kidney function is disrupted, the dose of the drug should be reduced 2 times, for adults - 125 mg once a day.

Cream

The termicone is prescribed externally to adults and children over 12 years of age.

Before applying the cream, it is necessary to clean and dry the affected areas. The cream is applied 1-2 times a day with a thin layer on the affected skin and adjacent areas, lightly rubbed.

In infections accompanied by intertrigo (under the mammary glands, in the interdigital spaces, between the buttocks, in the groin area), the places of application of the cream can be covered with gauze, especially at night.

Average duration of treatment for dermatomycosis of the trunk, shins, feet - 1 time per day infor 1 week; with candidiasis of the skin - 1-2 times a day for 1-2 weeks; at a multi-colored lichen - 1-2 times a day for 2 weeks.

Reducing the severity of clinical manifestations is usually noted in the first days of treatment. In the case of irregular treatment or premature termination, there is a risk of renewal of infection. In the event that there are no signs of improvement after 1-2 weeks of treatment, the diagnosis should be verified.

Dosage regimen for elderly patients is the same as for patients of other age groups.

Spray

The duration of the course of treatment and the dosage regimen is determined individually and depends on the localization of the process and the severity of the disease.

Outwardly the drug is prescribed to adults 1-2 times a day, depending on the indications. Before applying the drug, it is necessary to clean and dry the affected areas. The drug is sprayed on the affected skin and adjacent areas in an amount sufficient to moisturize them, and, in addition, applied to adjacent areas of intact skin:

• Dermatomycosis of the trunk, legs - treatment duration 1 week - frequency of application 1 time per day.
• Dermatomycosis of the feet - the duration of treatment 1 week - the frequency of application 1 time per day.
• Multicolored lichen - duration of treatment 1 week - multiplicity of application 2 times a day.

The dosing regimen for elderly patients is the same as for older adults.

Side effect

• dyspepsia;
• decreased appetite;
• nausea;
• diarrhea;
• feeling of overflow of the stomach;
• abdominal pain;
• Disturbances of taste sensations, including their loss (recovery occurs within a few weeks after cessation of treatment);
• hepatobiliary disorders (cholestatic jaundice);
• arthralgia;
• myalgia;
• agranulocytosis, thrombocytopenia, neutropenia;
• hives;
• rash;
• toxic epidermal necrolysis (Lyell's syndrome);
• anaphylactoid reactions;
• malignant exudative erythema (Stevens-Johnson syndrome);
• in places of application of a cream or a spray, redness, a sensation of itching or burning can occur.

Contraindications

• pregnancy;
• the period of breastfeeding;
• children under 3 years old and children weighing up to 20 kg, cream or spray - up to 12 years;
• hypersensitivity to the components of the drug.

Application in pregnancy and lactation

Experience in the use of the drug Termikon during pregnancy is limited, so its use in pregnancy is contraindicated.

Terbinafine is excreted in breast milk, therefore, if it is necessary to prescribe the drug during lactation, the question of stopping breastfeeding should be resolved.

In experimental studies teratogenicity of terbinafine was not revealed. To date, no developmental deficiencies have been reported with terbinafine.

Use in children

Tablets are contraindicated for children under the age of 3 years and children with body weight up to 20 kg. Cream or spray is contraindicated in children under 12 years of age.

Application in elderly patients

Older patients are prescribed the drug in the same doses as adults.

special instructions

It should be borne in mind that irregular use or early termination of treatment increases the risk of relapse.

The duration of therapy can be determined by the presence of concomitant diseases, the state of the nails at the beginning of the course of treatment.

If after 2 weeks of treatment with Termicon there is no improvement, it is necessary to repeatedly identify the pathogen and its sensitivity to the drug.

Systemic use in onychomycosis is justified only in case of total defeat of most nails, the presence of pronounced subungual hyperkeratosis, ineffectiveness of previous local therapy. In the treatment of onychomycosis, the clinical response is usually observed a few months after mycological cure and discontinuation of treatment, which is due to the rate of regrowth of a healthy nail. Removal of nail plates in the treatment of onychomycosis of brushes for 3 weeks and onychomycosis of the feet for 6 weeks is not required.

During treatment should monitor the activity of hepatic transaminases in the blood serum. In rare cases, after 3 months of treatment, cholestasis and hepatitis develop. If symptoms of liver dysfunction (weakness, persistent nausea, lack of appetite, abdominal pain, jaundice, dark urine or colorless feces) are detected, it is necessary to cancel the drug.

With extreme caution, the drug should be given to patients with psoriasis, as in very rare cases terbinafine can provoke an exacerbation of psoriasis.

Thermic spray or cream are for external use only.

Avoid contact with the eye, as it can cause irritation. In case of accidental ingestion of the drug into the eyes, they should be washed immediately with running water, and in case of persistent irritation, consult a physician.

When treating the drug, you should follow the general rules of hygiene to prevent the possibility of re-infection through the underwear and shoes. In the process (after 2 weeks) and at the end of treatment it is necessary to produce antifungal treatment of shoes, socks and stockings.

When developing allergic reactions, the drug should be discarded.

Impact on the ability to drive vehicles and manage mechanisms

Terbinafine does not affect the ability to drive vehicles and perform work that requires an increased concentration of attention and speed of psychomotor reactions.

Drug Interactions

Terbinafine inhibits the isoenzyme CYP2D6 and slows the metabolism of such drugs as tricyclic antidepressants and selective serotonin reuptake inhibitors (eg, desipramine, fluvoxamine), beta1-adrenoblockers (metoprolol, propranolol), antiarrhythmics (flecainide, propafenone),MAO type B inhibitors (eg selegiline) and antipsychotics (eg, chlorpromazine, haloperidol).

Inductors of cytochrome P450 isoenzymes (eg, rifampicin) can accelerate the excretion of terbinafine from the body, inhibitors of cytochrome P450 isoenzymes (eg, cimetidine) can slow it down. When used simultaneously with such drugs, a dose adjustment of terbinafine may be required.

With the simultaneous administration of terbinafine and oral contraceptives, a menstrual cycle may occur.

Thermicon reduces Caffeine clearance by 20% and increases its half-life by 31%.

Terbinafine does not affect the clearance of antipyrine, digoxin, warfarin.

Ethanol (alcohol) and other hepatotoxic drugs with concomitant use with Termicone increase the risk of hepatotoxicity.

Analogues of the medicinal product Thermicon

Structural analogs for the active substance:

• Atitis;
• Binafin;
• Lamisyl;
• Lamizil Dermgel;
• Lamizil Uno;
• Lamican;
• Lamella;
• Myconorm;
• Mycoterbine;
• Onihon;
• Tebicur;
• Terbized Agio;
• Terbisyl;
• Terbiks;
• Terbinafine;
• Terbinox;
• Terbifin;
• Tigal Sanovel;
• Ungusan;
• Fungoterbine;
• Cidokan;
• Exeter;
• Exifin.

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