Topical antifungal (allylamine) Pregnancy: There is no clinical experience with terbinafine in pregnant women; animal foetal toxicity studies suggest no adverse effects. Should not be used during pregnancy unless clearly necessary. Breast-feeding: terbinafine is excreted into breast milk (low systemic exposure after topical use) — the cream should not be used during breast-feeding, and infants must not be allowed to come into contact with any treated skin, including the breast.

Terbinafine 1% Topical

Brand names: Lamisil Once (single-application film for tinea pedis), Lamisil (1% cream / spray)

A topical allylamine antifungal cream used to treat superficial dermatophyte skin infections such as tinea pedis (athlete's foot), tinea cruris and tinea corporis, and cutaneous candidiasis.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Apply a thin layer of terbinafine 1% cream on and around the affected skin and rub in gently

Route: Topical (cutaneous)

Frequency: Once or twice daily

Adults and adolescents over 12 years of age. Likely duration of treatment by indication (UK SPC §4.2): tinea pedis 1 week; tinea cruris and tinea corporis 1 to 2 weeks; cutaneous candidiasis 2 weeks; pityriasis versicolor 2 weeks. Relief of symptoms is usually obtained within a few days; irregular use or an inadequate treatment period increases the risk of symptoms returning. If no improvement is obtained after 2 weeks, the diagnosis should be re-evaluated. Method of administration: the skin should be clean and dry before application; in reddened and weeping infection (under the breasts, between the fingers, buttocks or in the groin) the skin may be covered with a sterile compress after application, especially at night. Elderly: nothing indicates that a different dosage or a different side-effect profile applies. PAEDIATRIC: not recommended for children below 12 years of age due to insufficient safety data — experience in children is limited; no paediatric dose is stated. For external use only; may be irritating to the eyes — avoid eye contact and rinse thoroughly with running water if it occurs. Remove the cream and interrupt treatment in the event of an allergic reaction. Fire hazard: advise patients not to smoke or go near naked flames — fabric (clothing, bedding, dressings) in contact with the product burns more easily. Contains benzyl alcohol 10 mg per gram, plus cetyl and cetostearyl alcohol, which may cause local skin reactions. In candidiasis, acid pH soap is not recommended as it favours Candida growth.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to terbinafine or to any of the excipients

Side effects

Skin exfoliation and pruritus — common
Skin lesion, scab, skin disorder, pigmentation disorder, erythema, skin burning sensation — uncommon
Application site pain and application site irritation, and pain — uncommon
Dry skin, contact dermatitis, eczema — rare; eye irritation — rare
Hypersensitivity reactions including rash (frequency not known) — these require discontinuation of therapy, unlike the harmless local symptoms; in rare cases the underlying fungal infection may be aggravated

Interactions

No drug interactions are known with the topical forms of terbinafine (SPC §4.5)

Clinical monograph

How it works

Terbinafine inhibits fungal squalene epoxidase, impairing ergosterol synthesis in the cell membrane and causing accumulation of squalene, which is fungicidal against dermatophytes at the skin surface.

Prescribing in practice

It is for external cutaneous use only and should be kept away from the eyes; localised skin irritation, redness or itching at the application site can occur.
Continue treatment for the full recommended course even after symptoms settle, to reduce the risk of relapse, and keep the affected area clean and dry.
Topical therapy is generally insufficient for nail or scalp infection, which require systemic treatment.

Monitoring

No laboratory monitoring is required; review the affected area for clearance of the rash and any local irritation.

Counselling the patient

Apply a thin layer to the affected and surrounding skin and wash hands afterwards.
Complete the full course even if the rash clears early, and dry the area thoroughly (especially between the toes).
Seek advice if the rash worsens, spreads or fails to improve.

Evidence & guidelines

Topical terbinafine is an established effective treatment for tinea pedis and other dermatophytoses, supported by trial and Cochrane evidence of high cure rates for skin infection.

Reference: BAD Tinea Guidelines; NICE CKS Fungal Skin Infection; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways