Generic Lamisil

Indications for Generic Lamisil

Lamisil was introduced by Novartis pharmaceuticals.

Novartis Pharmaceuticals Corporation is the U.S. affiliate of Novartis AG, a world leader in healthcare.

Novartis has core businesses in pharmaceuticals, consumer health, generics, eye care, and animal health. In the U.S., Novartis has quickly achieved a reputation as an industry leader.

Important Information about Generic Lamisil

Lamisil medication are a highly effective treatment for mild to severe nail fungus infection (onychomycosis).

Lamisil medication is the No. 1 prescribed treatment for onychomycosis, used in millions of patients worldwide.

Lamisil medication has a high cure rate with a low rate of relapse; a proven record of safety; and an easy and convenient once-a-day dosing regimen.

Lamisil medication (terbinafine HCl) is indicated for the treatment of onychomycosis of the toenail or fingernail due to dermatophytes (tinea unguium).

Terbinafine, the active ingredient in Generic Lamisil , is the first available orally active allylamine. The allylamines are a novel chemical class of antifungal agents. Like azole antifungals, terbinafine selectively inhibits biosynthesis of ergosterol, a component of fungal cell membranes vital to membrane integrity and growth of the organism.

In a 48-week assessment of clinical success rates with Lamisil medication, the following results were reported:

• 70% achieved mycologic cure
• 59% achieved effective treatment (mycologic cure plus 0% nail involvement or 5 mm of new unaffected nail growth)
• 38% achieved mycologic plus clinical cure after 12 weeks of therapy (one 250-mg tablet daily) [mean time to overall success: 10 months]
• 85% did not relapse among those who achieved mycologic plus clinical cure of toenails (mycologic cure is achieved before clinical cure; relapse rate based on 38% of patients who demonstrated both mycologic cure plus clinical cure)

Many people try getting rid of nail fungus infection by applying over-the-counter surface treatments to their nails.

The surface of your nail is where it looks like the problem is. But the truth is the infection lives deep under your nail in your nail bed. That's why surface treatments you try on your own may not be able to reach it in sufficient amounts. Unlike surface treatments you try on your own, Generic Lamisil Tablets work through the bloodstream to target the infection where it lives, deep under the nail.

Onychomycosis: Information

Onychomycosis accounts for one third of fungal skin infections. Because only about one half of nail dystrophies are caused by fungus, the diagnosis should be confirmed by potassium hydroxide preparation, culture or histology before treatment is started. Newer, more effective antifungal agents have made treating onychomycosis easier.

Generic Lamisil (Terbinafine) and Sporanox (itraconazole) are the therapeutic agents of choice. Although the U.S. Food and Drug Administration (FDA) has not labeled Fluconazole (Fluconazole) for the treatment of onychomycosis, early efficacy data are promising. Continuous oral Lamisil (terbinafine) therapy is most effective against dermatophytes, which are responsible for the majority of onychomycosis cases.

Intermittent pulse dosing with itraconazole is as safe and effective as short-term continuous therapy but more economical and convenient. With careful monitoring, patients treated with the newer antifungal agents have a good chance of achieving relief from onychomycosis and its complications.

Onychomycosis

Onychomycosis is a fungal infection that can cause the nail to change color, often to a yellow/green or darker color.

Debris may collect under the nail, causing a foul smell. The nail may thicken and become flaky. Thick toenails, in particular, may cause discomfort in shoes and may even make standing and walking painful for the patient.

Onychomycosis of the fingernails may restrict typing, writing, and computer work; dressing; manual dexterity, fine touch, and sensitivity; and social interaction.

Onychomycosis is caused by dermatophytes, yeasts, and molds. Dermatophytes such as Trichophyton rubrum and Trichophyton mentagrophytes cause 91.3% of cases; yeasts such as Candida albicans cause 0.7% (usually fingernail infections); and molds such as Scopulariopsis, Scytalidium, Acremonium, and Fusarium cause 8% of cases.

Types of Onychomycosis

There are (4) four types of Onychomycosis:

• Distal and/or lateral subungual onychomycosis affects the nail bed and nail plate.
• Proximal subungual onychomycosis affects the proximal nail fold, with infection extending distally under the nail plate.
• Superficial white onychomycosis affects the top of the nail plate.
• Candidal onychomycosis affects the nail, skin, and mucous membranes.

Onychomycosis may present clinically in a manner that is similar to other nail disorders making it essential to differentiate such nail disorders from fungal infections. The correct diagnosis of onychomycosis is essential for appropriate antifungal therapy.

A KOH test is the most direct, cost-effective, and simplest technique to diagnose onychomycosis. Another approach is fungal culture, in which subungual debris is cultured on Sabouraud's dextrose agar containing cycloheximide to inhibit the growth of nondermatophytes. Genus and species identification of pathogens are determined from colonial morphology. Dermatophyte Test Medium can be inoculated with subungual debris. A color change in the medium in 7 to 10 days indicates the presence of a dermatophyte.

If required, a nail biopsy, in which a piece of the nail is sectioned and stained with periodic acid-Schiff (PAS), can be performed.

Clinical conditions that can resemble Onychomycosis include:

• Thickening of the nail bed or plate, which may be caused by conditions other than onychomycosis, such as lichen planus, pachyonychia congenita, pityriasis rubra pilarus, and psoriasis. All of these disease states involve hyperkeratosis that results in thickened nails.
• Separation of the nail plate, also called onycholysis. Conditions other than Onychomycosis that produce onycholysis include anemia, proximal candidiasis, carcinoma of the lung, circulatory disorders, endocrine disease, iron deficiencies, minor trauma, pregnancy, psoriasis, and syphilis.
• Discoloration of the nails, which may be due to other conditions. Black to dark brown nails may be produced by melanoma, nevi, or trauma. Green coloration may be due to Pseudomonas infection, but may also be due to Aspergillus or Blastomyces infection. White discoloration may have many causes, including autoimmune, cardiac, gastrointestinal, or renal diseases, metabolic disorders, neoplasia, psoriasis, stress, or trauma. Yellow nail syndrome may be associated with bronchitis, diabetes, arthritis, or hyperthyroidism.
• Nail pain may be produced by trauma, inflammatory diseases (such as gout, herpes, and paronychia), and vascular disorders (such as acute ischemia and systemic sclerosis).
• Transverse layering/lamellar splitting, also called onychoschizia, can occur as the result of repeated cycles of nail hydration and drying.
• Ridging of the nail plate (longitudinal and transverse) gives a beaded appearance. Longitudinal grooves may be caused by Darier-White disease, lichen planus, peripheral circulatory disorders, or rheumatoid arthritis.
• Pitting of the nails may be found in alopecia areata, eczema, or psoriasis, and in some forms of lichen planus. Pitting is usually confined to the fingernails, occurring rarely on the toenails.
• There are several systemic disorders that may present clinically in a form that resembles Onychomycosis:
• Argyria is a slate-gray or bluish discoloration of the skin due to deposits of silver albuminate that occurs after long-term administration of medicinal soluble silver salts.
• Drugs that may affect the nails include bleomycin, doxorubicin, 5-fluorouracil, retinoids, captopril, chlorpromazine, chloramphenicol, tetracyclines, psoralen phototherapy agents, thiazide, diuretics, and quinine. Intermittent cycles of chemotherapy may cause multiple transverse lines called Beau's lines.
• Clubbing of the nails may result from underlying pulmonary and other visceral diseases.
• Koilonychia, which causes the nail to have a concave appearance, is associated with anemia and may also be seen in onychomycosis.

A KOH (potassium hydroxide) test is the most direct, cost-effective, and simplest technique to diagnose onychomycosis. Conduct the test in the following manner:

-Cleanse the nail with alcohol to eliminate any bacterial contamination.
-Using a small curette or No. 15 scalpel, remove any subungual debris.
-Firmly scrape the undersurface of the affected nail plate, cutting as close to the leading edge as possible, to obtain a sample of the fungal debris.
-Place specimen (if nail clippings, first break into small pieces) on a slide with 1 drop of 10% to 20% KOH solution.
-Note: Stain such as Chlorazol black E (specific for chitin) may be added to help accentuate hyphae.
-Wait 30 minutes.
-Examine under microscope on low power and reduced light.

Test is positive if hyphae with a "boxcar" or "bamboo" appearance are present; the hyphae are generally larger and wider than skin cell membranes and will traverse several cells.

If you are sending a specimen to a lab for a KOH test, complete steps 1 through 3, and then follow the lab's instructions for shipping.

Most managed care organizations require a KOH test. If the test is negative and onychomycosis is still suspected, a nail culture should be performed.

Possible Side Effects of Generic Lamisil

Adverse effects, including headache, rash and gastrointestinal upset, have been observed more often with Generic Lamisil (terbinafine). Yet these side effects are uncommon and resolve with discontinuation of Lamisil medication .