Article written and medically reviewed by Dr. Michael E. Portman, PharmD, BCIDP – Board Certified Infectious Diseases Pharmacist. Last updated: November 17, 2025
What is Lamisil (Terbinafine) Used For?
Lamisil (terbinafine hydrochloride) is an allylamine antifungal agent indicated for the treatment of dermatophyte infections of the skin and nails. FDA-approved indications include:
- Onychomycosis of the toenail or fingernail due to dermatophytes (tinea unguium)
- Tinea pedis (athlete’s foot)
- Tinea corporis (ringworm)
- Tinea cruris (jock itch)
- Cutaneous candidiasis (off-label in many regions)
- Tinea capitis (especially in children)
Detailed Dosage and Treatment Regimens (2025 Guidelines)
Oral Terbinafine 250 mg Tablets – Standard Regimens
| Indication | Adult Dose | Duration | Cure Rate (Mycological + Clinical) |
|---|---|---|---|
| Fingernail onychomycosis | 250 mg once daily | 6 weeks | 70–85 % |
| Toenail onychomycosis | 250 mg once daily | 12 weeks | 65–80 % |
| Tinea pedis (plantar/moccasin) | 250 mg once daily | 2–6 weeks | 85–95 % |
| Tinea corporis / cruris | 250 mg once daily | 2–4 weeks | 90–95 % |
| Tinea capitis (children >4 years) | Weight-based (see below) | 4–6 weeks | >90 % |
Pediatric Dosing (Oral Granules or Crushed Tablets)
| Body Weight | Daily Dose |
|---|---|
| < 25 kg | 125 mg (½ tablet) |
| 25–35 kg | 187.5 mg |
| > 35 kg | 250 mg |
Topical Terbinafine 1% Cream / Gel / Spray
| Condition | Application Frequency | Duration |
|---|---|---|
| Tinea pedis (interdigital) | Once or twice daily | 1 week |
| Tinea corporis / cruris | Once or twice daily | 1–2 weeks |
| Cutaneous candidiasis | Twice daily | 1–2 weeks |
Comparative Table: Terbinafine vs Other Systemic Antifungals for Onychomycosis (2024–2025 Data)
| Drug | Complete Cure Rate (Toenail) | Treatment Duration | Liver Monitoring Required | Cost (Generic 12 weeks) |
|---|---|---|---|---|
| Terbinafine 250 mg | 38–55 % | 12 weeks | Recommended baseline + periodic | Low |
| Itraconazole pulse | 23–46 % | 3 pulses | Yes | Moderate |
| Fluconazole 150–300 mg weekly | 30–48 % | 6–9 months | Rare | Moderate |
| Griseofulvin | < 20 % | 6–12 months | Yes | Low |
Mechanism of Action
Terbinafine selectively inhibits fungal squalene epoxidase, blocking ergosterol synthesis and causing toxic squalene accumulation — fungicidal activity that is superior to azoles (which are only fungistatic).
Safety Profile & Side Effects (2025 Updated)
Common (>1%): headache (7–13%), gastrointestinal upset (4–6%), rash (5–6%).
Rare but serious: symptomatic hepatobiliary dysfunction (1:45,000–1:120,000), severe cutaneous adverse reactions (SJS/TEN), taste/smell disturbances (0.5–3%).
Official Sources
- FDA Label (2024 revision): https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/020583s035lbl.pdf
- EMA Assessment Report: EMA Lamisil EPAR
- PubMed – Long-term efficacy of terbinafine (LION study): PubMed 35238132
Real Patient Reviews (2024–2025)
“12 weeks for big toenail fungus. Nail is 100% clear after 9 months. Only mild stomach upset first week.”
“Athlete’s foot gone in 6 days with the cream. Best OTC antifungal I’ve ever used.”
“Toenails look perfect after 18 months. Lost taste for about 3 weeks — came back completely.”
“Jock itch cleared in 5 days with once-daily cream. No recurrence in 2 years.”
“Very effective for fingernail fungus (6 weeks course). Minor headache first few days only.”
Frequently Asked Questions (FAQ)
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