ArticleAntimicrobial agents and chemotherapy2014
Terbinafine in combination with other antifungal agents for treatment of resistant or refractory mycoses: investigating optimal dosing regimens using a physiologically based pharmacokinetic model.
Article in Antimicrobial agents and chemotherapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Exploring a Persistent Terbinafine - CYP2D6 Interaction Using Physiologically - Based Pharmacokinetic Modeling.The AAPS journal · 2026Article
- Terbinafine-Resistant Trichophyton Dermatophytosis in Australia.The Australasian journal of dermatology · 2026Article
- Diagnosis and management of invasive fungal infections due to non-Aspergillus moulds.The Journal of antimicrobial chemotherapy · 2025Review
- Novel antifungals and treatment approaches to tackle resistance and improve outcomes of invasive fungal disease.Clinical microbiology reviews · 2024Review
- Coated Microneedle System for Delivery of Clotrimazole in Deep-Skin Mycoses.Gels (Basel, Switzerland) · 2024Article
- Review
- A physiologically based pharmacokinetic model to optimize the dosage regimen and withdrawal time of cefquinome in pigs.PLoS computational biology · 2023Article
- Article
- Non-Journal of fungi (Basel, Switzerland) · 2023Review
- Diagnosis, treatment, and outcome in a dog with systemic Mycoleptodiscus indicus infection.Journal of veterinary internal medicine · 2021Article
- In vitro susceptibility testing for black grain eumycetoma causative agents.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2021Article
- The Antifungal and Synergistic Effect of Bisphosphonates inAntimicrobial agents and chemotherapy · 2021Article
- Administration and Dosing of Systemic Antifungal Agents in Pediatric Patients.Paediatric drugs · 2020Review
- CYP2C19 and 3A4 Dominate Metabolic Clearance and Bioactivation of Terbinafine Based on Computational and Experimental Approaches.Chemical research in toxicology · 2019Article
- Article
- Rational for Drug Dosimetry and Duration of Terbinafine in the Context of Recalcitrant Dermatophytosis: Is 500 mg Better than 250 mg OD or BD?Indian journal of dermatologyArticle
- Author's reply.Indian journal of dermatologyArticle
- Efficacy and Safety of Terbinafine 500 mg Once Daily in Patients with Dermatophytosis.Indian journal of dermatologyArticle
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Terbinafine is increasingly used in combination with other antifungal agents to treat resistant or refractory mycoses due to synergistic in vitro antifungal activity; high doses are commonly used, but limited data are available on systemic exposure, and no assessment of pharmacodynamic target attainment has been made. Using a physiologically based pharmacokinetic (PBPK) model for terbinafine, this study aimed to predict total and unbound terbinafine concentrations in plasma with a range of high-dose regimens and also calculate predicted pharmacodynamic parameters for terbinafine. Predicted terbinafine concentrations accumulated significantly during the first 28 days of treatment; the area under the concentration-time curve (AUC)/MIC ratios and AUC for the free, unbound fraction (fAUC)/MIC ratios increased by 54 to 62% on day 7 of treatment and by 80 to 92% on day 28 compared to day 1, depending on the dose regimen. Of the high-dose regimens investigated, 500 mg of terbinafine taken every 12 h provided the highest systemic exposure; on day 7 of treatment, the predicted AUC, maximum concentration (Cmax), and minimum concentration (Cmin) were approximately 4-fold, 1.9-fold, and 4.4-fold higher than with a standard-dose regimen of 250 mg once daily. Close agreement was seen between the concentrations predicted by the PBPK model and the observed concentrations, indicating good predictive performance. This study provides the first report of predicted terbinafine exposure in plasma with a range of high-dose regimens.
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