Treatment of onychomycosis with continuous terbinafine is associated with a low frequency of adverse events.151,172 These adverse events are generally mild to moderate in severity and are reversible. The more common adverse events involve the gastrointestinal tract, skin and central nervous system. Only a small proportion of patients discontinue treatment with terbinafine. Few drug interactions have been reported and some of these may arise because the allylamine inhibits the hepatic cytochrome P450 CYP2D6.173174 In the US and Canada, the package inserts156,175 state that pretreatment serum transaminase tests (alanine transaminase and aspartate transaminase) tests should be considered before initiating terbinafine therapy.

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