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Doctors' Answers to "Frequently Asked Questions" - Lamisil

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 07/14/2000]
Question: I have been taking Lamisil for the past 45 days to cure a long term fungal nail. The nail seems to be doing great - it is coming in clean for the first time in 15 years. Two weeks ago I completed blood work and all tests for liver problems came up negative. However 5 days ago I noticed that I had lost most of my sense of taste. I called the doctor who took me off the medicine. Is this a permanent side effect? The manufacturer's literature indicates that normal taste should return several weeks after discontinued use. Do you have any information on other patients who have lost taste and how long it has taken to regain the sense of taste.

Answer: This usually returns if the drug is stopped quickly.

[posted 07/2/2000]
Question: Doc gave me Lamisil, 2 tablets per day, 250mg each, for 6 weeks. After 5 weeks, my taste is now totally messed up. Went back to Doc's, he said they should come back after a few weeks. I came home and did searches on this med. and I now think I need to find a new Doctor. He has done NO LIVER checks, or anything else. My taste is still messed up, it has been over 5 weeks since I stopped taking the Lamisil and it looks as if he gave me a DOUBLE DOSE to begin with.
WILL MY TASTE BUDS correct themselves. Is there any cases that have not had their taste buds go back to normal? Should I go back to the Doc and have a Liver test? I have ended up loosing about 15lbs in the past 5 weeks because I can't stand to eat hardly anything as it tastes too salty, or just plain gross!Not that I didn't need to loose weight, don't we all, but not in this way! Thanks for your time.

Answer: If there is no change in 2 weeks or so get liver function checks. The usual toxicity from this drug will abate in a few weeks off the medication. Although there may have been some liver function abnormalitys the time you were on the medication was of such a short duration that I would be surprised that you would have any permanent toxicity. You are correct about the dosage(nail bed infections)being higher than recommended.

[posted 04/26/2000]
Question: Is Lamasil effective in treating the entire body with general fungal infections, and how often does the fungus return when treated with Lamisil? I've had frequent reoccuring vaginal yeast infections since my first diagnosis at age 12. I've tested negative for Candida and believe it may be a different fungus. The only help has been controlling my sugar and alcohol intake, but it is not 100% efective. I've just been perscribed 14 daily doses of Lamisil 250mg for a small skin rash. Will this clear up the fungus in the entire body?

Answer: Depending on the type of fungal infection and the severity certainly can.

[posted 04/4/2000]
Question: I was recently perscribed Lamisil by my doctor for
onychomycosis. He perscribed three one week doses
of 250 mg per day separated by three weeks of no
medication. This is drastically different than the
information provided by the manufacturer which says
250 mg/day for 12 weeks for infections of the toe
nail. I couldn't find any information on this new
treatment schedule. Have you heard of this and is it
still effective in treating onychomycosis?

Answer: This is a regimen used successfully by a competitor and subsequently some physicians are using this with Lamisil with little clinical data to effectiveness that I am aware of. Sporonox has clinical data that this type is effective with Sporonox. A little more expensive, but at least is documented. Lamisil might work here, but no adequate research. This approach however, does lower the risk of liver problems-another benefit.

[posted 04/4/2000]
Question: I am a U.S. Marine who has a rather severe case of toenail fungus. It is only on my big toe of my left foot, but it has recently spread to the next toe. It is painful because of the deformity it causes (elevated nail is very sensitive). A Navy Doctor prescribed Lamisil 500MG per day for one week, repeat for four months. This is different from the way all other doctors seem to prescribe the medication... I questioned my Doc, but he seemed to not appreciate the question... is this an okay way to prescribe? Is it safe, relatively speaking? Any info would be GREATLY appreciated.

Answer: Yes, but this type of drug often will not fix the problem when dosed in this manner. Sporonox will, ask him to switch to sporonox instead, this has been documented as effective with sporonox(not lamisil). You will need occasional liver function tests and it will take a minimum of six months to fix(often one year).

[posted 01/12/2000]
Question: I was on Lamisil 250 mg for 90 days. My last pill was on 12/25/99. It is now 1/12/99 and would like to stop taking my birth control pills (Leven-28) this month. Is there any reason why I should not try and get pregnant at this time? I have been told it stays in your system 90 days after taking it, I have not taken it daily for 20 days. What are the risks! Thanks

Answer: No clear way of knowing. I would avoid any pregnancy for the first 30 days, that should be more than enough. Lamisil is a Class B which is a pretty low risk as drugs go.

[posted 11/26/1999]

Answer: Hair loss and skin rashes are seen, but I have not seen patients with any dental problems nor is it listed in the PDR. However, for uncommon problems, I'd check with the company, Novartis 888-669-6682.

[posted 08/28/1999]
Question: Over a year and half ago, I noticed a problem developing with my toenails but did not pay it much attention until it worsened considerably. I eventually asked our family doctor about Lamisil and was told that it might adversely effect the oral contraceptive method I was using so I decided against starting Lamisil. In May 1999, I started taking Lamisil 250mg and have noted no apparent change in the appearance of my toenails. I returned for a f/u last week and was told by the podiatrist that we should've been able to see some change by now. He recommended outpatient surgery to remove the affected nails (which are apparently pretty bad) and clear the way for new nails to grow and also prescribed me 3 more months of Lamisil 250mg.
Novartis' literature states that regular treatment for toenail fungus is 3 months, and that it will take between 10-12 months for new nails to grow.
My questions are: 1) do the toenails have to be removed in order to obtain healthy nails, and 2) would there be added benefit from continuing the med without removing the toenails or would it not make any more difference?
Also, I had been planning to discontinue Lamisil after the initial 3 months in order to get pregnant, but in Novartis' literature, I read that the drug stays in your system for months and has long-term effects. In the FAQs here, it was advised against risking a fetus by taking Lamisil. Due to these long-term effects, is it then unsafe to become pregnant immediately after stopping Lamisil oral treatment?
Thanks for your advice.

Answer: It takes at least 6 months to cure toe nails and commonly a year. In my experience, only about 30% success if achieved even after this length of time. Getting pregnant while you are off the Lamisil is ok, taking it with a fetus is not.

Lamisil - treatment for jock itch [posted 1/12/99]
Question: I've read on your site that Lamisil is frequently prescribed for toenail fungus, but has it been shown to be effective as a cure for Jock Itch?

Answer: Yes, but it's like using a sledge hammer for a fly.

Lamisil and loss of senses [posted 1/8/99]
Question: I have taken lamisil 250 mg per day for 40 days. I have lost my sense of smell mostly and I have no sense of taste. My doctor checked liver and my blood work up checked out negative. My doctor put me on amoxcillin 1500 mg per day to try and clear up possible sinus infection and he said it was the easiest thing to try first. If the lamisil caused this, how long would you guess it would take to wear off?

Answer: Well if it is the lamisil, stop it for a month and see.

Lamisil - Oral use during pregnancy [posted 1/5/99]
Question: The references I found list the drug as a Pregnancy Risk Category B, which to me indicates minimal risk. Your response of "absolutely not" leads me to believe that there is more than minimal risk. Could you expand on potential risks? What frequency rates, etc. Also, do you have any references/sources of research findings/clinical trials you could share so I could research this topic further. Thank you very much for your time, this information will be extremely important to me.

Answer: Although Lamisil is a class B drug, treatment for a fungal toenail infection would not be worth the risk to the fetus. This type of infection is easily treated post-pregnancy and will not lead to systemic fungal infection or any other complications at all other than an ugly nail. I don't think this is worth any risk, however, small to your child. Get yourself treated after the pregnancy.

Lamisil and loss of taste [posted 1/5/99]
Question: I have been taking Lamisil for over 2 months and suddenly lost some of my sense of taste. Sweet items have virtually no taste for me at this time. Could this be a side effect of Lamisil? I know liver problems can contribute to loss of taste.

Answer: Certainly possible, have you had regular liver function tests? You might stop the medication for a couple of weeks and see what happens.

Possible Lamisil Allergy [posted 11/11/98]
Question: I have been on Lamisil for 3 weeks and yesterday I broke out all over with hives. Could this be from the Lamisil? I have had hives before but just in 1 or 2 areas of my body.

Answer: Maybe, get your liver functions tested and stop the lamisil. Check with your doctor.

Lamisil & Pregnancy [posted 11/3/98]
Question: Is it safe for a pregnant woman to take Lamisil 250mg 1 tab/day to treat a toenail fungal infection, especially during the first trimester of pregancy?

Answer: Absolutely not.

Lamisil & White Blood Count [posted 10/6/98]
Question: My husband was given a 3 month supply of Lamisil without any monitoring of his liver or blood functions during this period. Before taking the drug, his white blood count was in the low-normal range. When he went for his annual check-up, it was found that his white blood count had dropped from 3800 to 2000. He has been having neutropenia since then and it has been over a year. I know that neutropenia or leucopenia is one of the possible side of this drug. How can I post this information in order to see if this has happened to other people taking Lamisil? Thank you

Answer; I would have your doctor turn in and adverse drug reaction form with the FDA. Also, check with the medical department of the manufacturer, Novartis 888-669-6682.

Lamisil & Gout [posted 10/6/98]
Question: Are there any problems with taking lamisil while also taking gout medication? Is gout exacerbated by lamisil? It would seem so in my case.

Answer; No obvious interaction causing gout that is. Which gout medications are you referring to?

Lamisil [posted 8/11/98]
Question: Is there any research on how Lamisil effects oral contraception?

Answer: Check with the scientific department of Novartis: 888-669-6682. I'm not aware of specific studies.

Lamisil - Severe Side Effect [posted 8/5/98]
Question: My husband took Lamisil tablets for toe fungus. He took the 80 tablets, which were prescribed by his doctor and it had terrible side effects on him. His skin starting turning black and looked like alligator skin. We did not know what was causing this, but it started happening almost as soon as he started taking it and his skin got so black it was starting to get on his face. After he had stopped taking the Lamisil it took quite some time for his skin to get back to normal, the dark skin just started rolling off of him until it got back to normal. He was also sick after he started taking the Lamisil tablets. I would be afraid for any of my family or myself to ever take this medication again. I think this medication should be tested further for more side effects than was listed.

Answer: This can be a fairly toxic drug if not monitored correctly. I personally think too many physicians treat fungal infections that are of no concern whatsoever - compared to the potential toxicity.

Rash, Lipitor and Lamisil
Question: I have been taking both Lipitor and Lamisil for 3 and one half weeks. I developed a rash that forms scratch marks and red streaks and then an itchy rash that disappears in about 30 minutes only to reappear later. I discontinued the Lamisil after the doctor visit a week ago, but I still have the condition. Could I be having a reaction to the Lipitor?

Answer: Hard to know, both of these drugs potentially affect the liver. Have you had liver function tests? I'd stop both, and restart the lipitor after the problem is completely gone a month or so. If it goes then assume it is the lamisil or the interaction of the two.

Question: What are the side effects of lamisil? Is it safe?

Answer: Lamisil(terbinafine) is an antifungal drug used mainly to treat infections in the nails. It potentially has liver toxicity and liver function tests should be followed closely. Other potential side effects include nausea, rash, and flatulence. In general, it is well tolerated except for potential liver toxicity.

Question: What is a possible reaction to using 250 mg Lamisil once per day and the ingestion of alcohol?

Answer: Potential liver toxicity.

Question: Is there any over the counter medication similar to Lamisil?

Answer: Lamisil is a antifungal cream and is fairly potent. You can buy antifungal preparations over the counter which are not as potent, but will usually work over time. Tinactin, NP 27, etc., are all effective with longer use.

Lamisil and Drinking
Question: How long must I wait before drinking alcohol if I take 1 250 mg tablet a day?

Answer: There is no absolute contraindication to combining Lamisil and Alcohol. Lamisil can potentially affect the liver and so can alcohol. The combination is not a good idea;but, checking liver functions are regularly checked(and intake moderate) this is probably OK.

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