Drawbacks

Intermittent terbinafine therapy has been associated with few adverse events. Adverse events are generally mild to moderate and are reversible. The spectrum of adverse effects is similar to that seen with the continuous terbinafine regimen. The pulse terbinafine regimen is not indicated for the treatment of onychomycosis, and therefore there are no monitoring guidelines in the US.

Table 33.4 Treatment of dermatophyte toenail onychomycosis using terbinafine pulse therapy

Year

Authors

Study type

No. of

Regimen

Treatment

Follow up

Efficacy measure (%)

evaluable patients

duration

(post-treatment)

MC CR

CC

2001

Gupta etal.™

Single-blind, randomised parallel, comparative (pulse itraconazole + pulse terbinafine)

90

500 mg/day 1 wk/month

3 months

18 months

44/90 (49) 41/90 (46)*

29/90 (32)

1996

Alpsoy eta!™

Open, randomised comparative (continuous terbinafine)

23

500 mg/day 1 wk/month

3 months

12 months

17/23 (74)

1996

Tosti et a! ™

Open, randomised comparative (pulse itraconazole, continuous terbinafine)

20

500 mg/day 1 wk/month

4 months

10 months

16/20 (80) *

10/20 (50)

See Table 33.1 for abbreviations

See Table 33.1 for abbreviations

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