Terbinafine Pulse Dosing: A New Toenail Fungus Treatment

Exploring Terbinafine Pulse Dosing for Toenail Fungus Treatment

Toenail fungus, medically known as onychomycosis, is a persistent condition that can be challenging to treat. Oral terbinafine is an antifungal medication that has been shown effective against stubborn nail bed infections when taken continuously for 3 months. However, some doctors are now exploring "pulse dosing" regimens to cut down on terbinafine use while still beating bad fungal cases.

Understanding Terbinafine Pulse Therapy

Terbinafine pulse therapy involves taking terbinafine tablets in pulses, with periods on the antifungal alternating with planned off-periods:

• Typical pulse scheme: 1 week on medicine, 3 weeks off
• This dosing allows nails chance to regrow fresh during drug-free weeks
• When antifungal clears from body, it can better attack any lingering fungi

Research shows terbinafine stays in the bloodstream for up to 7 days after the last dose. So nails remain protected even during off-weeks for successful pulse treatment.

Candidacy for Pulse Regimen

While studies are still ongoing, initial results suggest terbinafine pulse therapy works for:

• Toenail fungus cases covering 50% or less nail surface
• Patients who cannot tolerate continuous 3-month regimens of terbinafine
• Those at higher risk for liver issues on long-term antifungal medications

Consult a podiatrist or dermatologist to discuss if pulse therapy is appropriate for your individual fungal infection and health status.

Terbinafine Pulse Dosing Protocol

If pulse treatment is deemed suitable, a doctor will provide exact dosing instructions. But standard pulse protocol for terbinafine is:

Weeks 1-4

• Take 250mg terbinafine tablet once daily for 1 week
• Do not take tablet for next 3 weeks

Weeks 5-8

• Take 250mg terbinafine tablet once daily for 1 week
• Do not take tablet for next 3 weeks

Weeks 9-12

• Take 250mg terbinafine tablet once daily for 1 week
• Do not take tablet for next 3 weeks

Total pulse dosing treatment is 12 weeks. Track each on/off week carefully for best results.

Enhancing Terbinafine Pulse Treatment

Careful foot hygiene and nail care habits are important while pulse dosing to help terbinafine work and prevent fungal reinfection of growing nails:

Disinfect Shoes & Socks

Use antifungal sprays or UV shoe sanitizers to kill lingering fungus inside footwear between wears to avoid recontamination while pulse dosing.

Rotate Shoes

Wearing different pairs of shoes daily without repeating allows insides proper time to fully dry out to prevent fungal spread.

Clip Toenails Properly

Trim nails straight across, then file to reduce thickness and trauma against shoes to encourage new, healthy nail growth underneath.

Use Antifungal Foot Powder

Dust feet daily with medicated powders containing zinc, oregano or undecylenic acid to curb fungal spread across skin.

Moisturize Feet

Apply antifungal creams post-showering to prevent cracking skin vulnerable to reinfection around treated nails.

Pulse Dosing Considerations

Before undergoing terbinafine pulse treatment, discuss with your doctor:

Total Length of Therapy

Standard dosing described is 12 weeks, but some cases require longer pulse protocols from 6 to 9 months for stubborn fungal nail infections.

Follow-Up Visits

Plan appointments every 4-8 weeks for providers to monitor infection healing progress and adjust therapy duration accordingly.

Bloodwork Needs

Liver enzyme tests at initiation then again at weeks 4 and 8 ensure safe terbinafine metabolizing on pulse schedule.

Potential Side Effects

Upset stomach, diarrhea, skin rash or headaches may manifest during on-weeks then resolve off-weeks when not taking tablets.

Interactions

Avoid mixing terbinafine with specific antidepressants, blood thinners or heart medications due to risks like irregular heart rhythm.

Proper pulse protocol guided by a medical professional offers the best chance for clearing difficult nail fungus while minimizing oral antifungal use.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.