Exifin - instructions for use, analogs, reviews and release forms (tablets 250 mg, cream or ointment for external use 1%) of the drug for the treatment of skin fungus, nails, candidiasis, other mycoses in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Exifin. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of experts on the use of Exifin 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 Exifin in the presence of existing structural analogues.Use to treat fungal skin, nails, candidiasis or thrush and other fungal infections in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Exifin - an antifungal drug, belongs to the group of allylamines. Has a wide range of antifungal action. At low concentrations, it has a fungicidal effect on Trychophyton dermatophytes (T. rubrum, T. menlagrophytes, T. tonsurans, T. verrucosum, T.violaccum), Microsporum canis, Epidermophyton floccosum, mold fungi (eg, Aspergillus, Cladosporium, Scopulariopsis brevicalius) yeasts, mainly Candida albicans (candida), and some dimorphic fungi. Candida fungi and its mycelial forms, depending on the type of fungus, have a fungicidal or fungistatic effect. Terbinafine disrupts the early stage of biosynthesis of the main component of the cellular membrane of the ergosterol fungus by inhibiting the squalene-epoxidase enzyme. Squalene-epoxidase is not associated with the cytochrome P450 (CYP450) system, so terbinafine does not affect the metabolism of hormones and drugs whose metabolism is associated with CYP450.

When administered orally, it accumulates in the skin, nails and hair in an amount that has a fungicidal effect.

Systemic treatment of varicolored lichen, caused by Malassezia furfur, is ineffective.But the use of Exifin cream for the treatment of this disease is allowed.

Composition

Terbinafine hydrochloride + excipients.

Pharmacokinetics

When oral intake is well absorbed, after 0.8 h absorbed half of the dose; After 4.6 h half of the dose taken is distributed in the body. Bioavailability - 80%. The intake of food does not affect the bioavailability of terbinafine. Terbinafine binds intensely to blood plasma proteins (99%), spreads rapidly in tissues, penetrates the dermal layer of the skin and nail plates. Penetrates the secretion of sebaceous glands and accumulates in high concentrations in the hair follicles, in hair, skin and in the subcutaneous tissue. After a few weeks of treatment, it accumulates in nails and in concentrations that provide a fungicidal effect. Biotransformiruetsya in the liver to inactive metabolites: 80% of the accepted dose is excreted in the urine in the form of metabolites, the rest (20%) with a caloric mass. Do not cum in the body. The age of the patients does not affect the pharmacokinetics of terbinafine, however, elimination may decrease with kidney or liver damage, leading to high concentrations of terbinafine in the blood. It is excreted together with breast milk.

Indications

• trichophytosis, microsporia, rubrofitia caused by susceptible pathogens, incl. foot mycoses and inguinal epidermophyty;
• mycoses of the scalp (trichophytosis, microsporia);
• mycosis of the skin and nails, caused by Trychophyton (T. rubnim, T. mentagrophytes, T. verrucosum, T. violaceum). Microsporum (M. canis, M. gypseum) and Epidermophylum floccosum;
• onychomycosis;
• severe, common dermatomycosis of the smooth skin of the trunk and extremities that require systemic treatment;
• colored lichen;
• candidiasis (thrush) of the skin and mucous membranes.

Forms of release

Tablets 250 mg.

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

Instructions for use and how to use them

Pills

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

Onychomycosis

Usual dose: 250 mg once a day. The duration of therapy is about 6-12 weeks. If the fingernails of the hands and feet are damaged (except for the large finger, groans), or when the patient is young, the duration of the treatment may be less than 12 weeks. With a large toe infection, a 3-month course of treatment is usually sufficient. In rare cases, with a slower rate of nail growth, longer treatment may be required up to 6 months or more.

Fungal skin infections

The duration of treatment with interdigital, plantar, or "socks" localization of infection is 2-6 weeks, with mycoses of other parts of the body: shins - 2-4 weeks, trunks - 4 weeks, with mycoses caused by Candida - 2-4 weeks; with mycosis head caused by Microsporum canis - more than 4 weeks.

Children are usually prescribed 125 mg (1/2 tablet). The duration of treatment of mycosis of the scalp is about 4 weeks, while infection with Microsporum canis may be longer.

At a body weight of less than 20 kg, 62.5 mg (1/4 tablet) once a day, at a weight of 20 to 40 kg, 125 mg (1/2 tablet) once a day, with a mass of more than 40 kg, 250 mg 1 tablet) once a day.

Older patients prescribe the drug in the same doses as adults.

In severe violations of the liver and / or kidney function (SC 50 ml / min or creatinine concentration in the blood more than 300 μmol / l) - 125 mg once a day.

Cream

Outwardly. Before applying Exxin, it is necessary to clean and dry the affected areas. The cream is applied a thin layer on the affected skin and adjacent areas and 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 and frequency of application:

Dermatomycosis of the trunk, legs - 1 week 1 time per day;

Inguinal epidermophytosis - 1-2 weeks 1 time per week.

Dermatomycosis of the feet - 1 week 1 time per day.

Candidiasis of the skin - 1-2 weeks 1 or 2 times a day.

Multicolored lichen - 2 weeks 1 or 2 times a day.

The duration of treatment depends on the indication and severity of the disease. Reduction in the severity of clinical manifestations is noted in the first days of treatment.

For the prevention of relapses mycosis stop - 2-3 courses for 2 weeks with a break of 7 days.

Dosage regimen of the drug Exifin in the elderly does not differ from the above.

Side effect

• feeling of a full stomach;
• dyspepsia;
• nausea;
• loss of appetite;
• stomach ache;
• diarrhea;
• violation of taste perception, incl. loss, which is restored a few weeks after the cessation of treatment;
• jaundice;
• hepatitis;
• paresthesia;
• dizziness;
• depression;
• a feeling of heightened anxiety;
• arthralgia;
• myalgia;
• neutropenia, agranulocytosis, thrombocytopenia;
• hives;
• erythema multiforme;
• systemic allergic reactions (reactions like serum sickness,angioedema);
• severe skin reactions (toxic epidermal necrolysis, Stevens-Johnson syndrome, photosensitivity);
• headache;
• bad feeling;
• feeling tired;
• increased hair loss;
• itching and burning of the skin, hyperemia in the place of application.

Contraindications

• children's age to 2 years, tk. there is insufficient data on the use of the drug by children weighing less than 12 kg;
• pregnancy;
• the period of breastfeeding;
• hypersensitivity to the components of the drug.

Application in pregnancy and lactation

Exifin is contraindicated in pregnancy and lactation.

Use in children

Contraindicated in children under 2 years of age, t. There is not enough data on the use of the drug by children weighing less than 12 kg.

Children are usually prescribed 125 mg (1/2 tablet). The duration of treatment of mycosis of the scalp is about 4 weeks, while infection with Microsporum canis may be longer.

At a body weight of less than 20 kg, 62.5 mg (1/4 tablet) once a day, at a weight of 20 to 40 kg, 125 mg (1/2 tablet) once a day, with a mass of more than 40 kg, 250 mg 1 tablet) once a day.

Application in elderly patients

Older patients prescribe the drug in the same doses as adults.

special instructions

Irregular application of Exifin or premature discontinuation of treatment leads to a relapse of the disease.

The duration of therapy can be influenced by factors such as the presence of concomitant diseases, the condition of the nails at the beginning of the course of treatment.

If after 2 weeks of treatment of skin infection there is no improvement, it is necessary to re-determine 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 cessation 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.

In the presence of severe renal failure (creatinine clearance less than 50 ml / min or creatinine in the blood more than 300 μmol / L), if the liver function is disrupted, the dose of terbinafine should be reduced by half.

With reduced liver function, appoint a half-adult dose. During treatment, it is necessary to control the level of liver transaminases in the blood serum. In rare cases, after 3 months of treatment, there is cholestasis and hepatitis. If there are signs of impaired liver function (weakness, persistent nausea, loss of appetite, abdominal pain, jaundice, darkening of the urine or colorless stools), the drug should be discarded.

The administration of terbinafine to psoriasis patients requires increased discretion; in very rare cases terbinafine can trigger an outbreak of psoriasis.

When treating terbinafine, general hygiene rules should be followed to prevent the possibility of re-infection through linens and shoes. In the process of treatment (every 2 weeks) and at the end of it, it is necessary to produce antifungal treatment of shoes, socks and stockings.

Impact on the ability to drive vehicles and manage mechanisms

Exifin does not affect the ability to drive and perform work that requires increased concentration.

Drug Interactions

Virtually no effect on the clearance of drugs metabolized with the participation of cytochrome P450 (eg, cyclosporine, terfenadine, tolbutamide, triazolam, oral contraceptives).

Inhibits CYP206 and prevents the metabolism of such drugs as tricyclic antidepressants and selective blockers of the seizure of serotonin (desipramine, fluvoxamine), beta-adrenoblockers (metoprolol, propranolol), antiarrhythmics (flecainide, proavfenon), MAO inhibitors of type B (sellegin) and antipsychotic (chlorpromazine , haloperidol).

Drugs - inducers of CYP450 enzymes (eg, rifampicin) can accelerate the excretion of Excyxin from the body.

Drugs - inhibitors of CYP450 (for example, cimetidine) can slow the metabolism and excretion of terbinafine from the body. With the simultaneous use of these drugs, a dose adjustment of terbinafine may be required.

Possible violation of the menstrual cycle with the simultaneous administration of terbinafine and oral contraceptives.

Decreases Caffeine clearance by 21% and prolongs its half-life by 31%.

Does not affect the clearance of antipyrine, digoxin, warfarin.

Ethanol (alcohol) and other hepatotoxic drugs increase the risk of developing a hepatotoxic effect.

Analogues of the drug Exifin

Structural analogs for the active substance:

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

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