Anpar

Anpar Cream

Anpar is an allylamine with a range of antifungal activity. It is fungicidal against dermatophytes, moulds and certain dimorphic fungi. Anpar is either fungicidal or fungistatic against yeasts, depending on the species. Anpar interferes with fungal ergosterol biosynthesis by inhibiting squalene epoxidase in the fungal cell membrane at an early stage. This leads to a deficiency in ergosterol and to intracellular accumulation of squalene, resulting in fungal cell death. Anpar is highly effective in fungal infections of the skin, hair and nails caused by Trichophyton spp., Microsporum spp. and Epidermophyton floccosum. It is also effective against yeast infections of the skin, principally those caused by the genus candida. Topical terbinafine appears to be effective in pityriasis versicolor due to Pityrosporum arbiculare.

Uses

Anpar cream is used for the treatment of the following dermatological infections: interdigital tinea pedis (Athlete’s foot), tinea cruris (jock itch) or tinea corporis (ring worm) due to susceptible organisms and planter tinea pedis (mocasin type) due to Trichophyton spp. 

Anpar tablet is used for the treatment of onychomycosis of the toe nail or finger nail due to dermatophytes and also by non-dermatophyte fungi.

Anpar is also used to associated treatment for these conditions: Onychomycosis, Pityriasis versicolor, Sporotrichosis, Tinea Capitis, Tinea Corporis, Tinea Cruris, Tinea Pedis, Cutaneous candidiasis, Severe Tinea Corporis, Severe Tinea Cruris, Severe Tinea Pedis

Anpar

Trade Name Anpar
Generic Terbinafine
Terbinafine Other Names Terbinafina, Terbinafine, Terbinafinum
Weight 1%
Type Cream
Formula C21H25N
Weight Average: 291.4299
Monoisotopic: 291.198699805
Protein binding

Terbinafine is >99% bound to proteins in plasma, mostly to serum albumin, high and low density lipoproteins, and alpha-1-acid glycoprotein to a lesser extent.

Therapeutic Class Drugs for subcutaneous and systemic mycoses, Topical Antifungal preparations
Manufacturer Doctor’s Chemical Works Ltd
Available Country Bangladesh
Last Updated: June 23, 2021 at 11:25 am

Structure

Anpar
Terbinafine Structure

Dosage

Anpar dosage

Topical application:

Anpar cream to affected areas once or twice daily for 1-2 weeks may be adequate for fungal infections of the skin but certain infections may require oral Anpar tablet therapy.Usual duration of treatment of Anpar cream:

  • In Tinea corporis and Tinea cruris: 1-2 weeks.
  • In Tinea pedis: 2-4 weeks (One week of treatment will normally suffice if the cream is applied twice daily.).
  • In Cutaneous candidiasis: 1-2 weeks
  • In Pityriasis (tinea) versicolor: 2 weeks.

To prevent relapses in fungal infection, treatment should be continued for a adequate length of time. To apply Anpar cream clean and dry the affected areas thoroughly and apply the cream once or twice a day to the affected skin and surrounding area in a thin layer and rub in lightly. In the case of intertriginous infections the application may be covered with a gauze strip, especially at night.

Oral administration:

Anpar tablet is essential for hair or nail infections:

  • The usual oral dose: Anpar 250 mg daily for 2 to 12 weeks depending upon the infection.
  • Finger nail onychomycosis: Anpar 250 mg once daily for 6 weeks.
  • Toe nail onychomycosis: Anpar 250 mg once daily for 12 weeks.

Side Effects

Anpar Tablet: Abdominal discomfort, anorexia, nausea, diarrhoea, headache, rash and urticaria occasionally with arthralgia or myalgia. Less frequently taste disturbance. Rarely liver toxicity, photosensitivity, serious skin reactions etc.

Anpar Cream: Redness, itching, or stinging; rarely allergic reactions.

Precaution

Terbifine cream is for external use only. Contact with eyes should be avoided.Good general hygiene is necessary in conjunction with the use of Anpar in order to prevent reinfection (eg. from underwear, socks,shoes etc).

Anpar tablet is not recommended for patients with chronic or active liver disease. Before prescribing terbinafine, pre-existing liver disease should be assessed. Hepatotoxicity may occur in patients with and without pre-existing liver disease. Pretreatment serum transaminase (ALT and AST) tests are advised for all patients before taking terbinafine tablets.

Interaction

In vivo studies have shown that terbinafine is an inhibitor of the CYP450 2D6 isozyme. Drugs predominantly metabolized by the CYP450 2D6 isozyme include the following drug classes: tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers, antiarrhythmics class 1C (e.g., flecainide and propafenone) and monoamine oxidase inhibitors Type B. Co-administration of terbinafine should be done with careful monitoring and may require a reduction in dose of the 2D6-metabolized drug.

Food Interaction

  • Limit caffeine intake. Anpar may reduce the metabolism of caffeine by approximately 19%, monitor for increased effects of caffeine.
  • Take with or without food.

Volume of Distribution

A single 250mg oral dose of terbinafine has a volume of distribution at steady state of 947.5L or 16.6L/kg.

Half Life

Oral terbinafine has an effective half life of approximately 36 hours. However, the terminal half life ranges from 200-400 hours as it distributes into skin and adipose tissue. 1% topical terbinafine's half life increases over the first seven days from approximately 10-40 hours.

Clearance

A single 250mg oral dose of terbinafine has a clearance of 76L/h or 1.11L/h/kg.

Pregnancy & Breastfeeding use

Anpar tablet: There are no adequate and well controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, and because treatment of onychomycosis can be postponed until after pregnancy is completed, it is recommended that terbinafine not be initiated during pregnancy. After oral administration, terbinafine is present in breast milk of nursing mothers. Treatment with terbinafine in not recommended in nursing mothers. 

Anpar cream: Foetal toxicity and fertility studies in animals suggest no adverse effects. There is no clinical experience with terbinafine in pregnant women; therefore, unless the potential benefits outweigh any potential risk, terbinafine should not be administered. Anpar is excreted in breast milk and therefore mothers should not receive terbinafine treatment whilst breast-feeding.

Contraindication

Hypersensitivity to Anpar or any of the excipients in thepreparation

Special Warning

Use in Children: Anpar cream appears to be an effective and well-tolerated treatmenr of tinea corposis and tinea cruris in children.

Use in Elderly: Anpar appears to be safe in the elderly. The dose should be reduced by half if significant hepatic or renal impairment is present.

Acute Overdose

Clinical experience regarding overdose with terbinafine tablets is limited. Doses up to 5 grams (20 times the therapeutic daily dose) have been taken without inducing serious adverse reactions. The symptoms of overdose included nausea, vomiting, abdominal pain, dizziness, rash, frequent urination, and headache.

Storage Condition

Store in a cool and dry place, protected from light.

Innovators Monograph

Anpar contains Terbinafine see full prescribing information from innovator // generic/terbinafine/terbinafine-hydrochloride-tablet-prescribing-information" Monograph

FAQ

What is Anpar prescribed for?

Anpar are used to treat fungal infections of the toenails and fingernails. Anpar is in a class of medications called antifungals.

How safe is Anpar?

As with most classes of drugs, Anpar can potentially lead to liver problems.however Anpar is safer than perhaps it is perceived, and minor side effects are far more likely for most patients than serious liver damage.

What are the side effects of Anpar?

Common side effects are include:

  • rash.
  • headache.
  • diarrhoea.
  • feeling or being sick (nausea or vomiting)
  • a smaller appetite than usual.
  • stomach ache.
  • indigestion.
  • muscle or joint pain

How fast does Anpar work?

Anpar work within 1 week after starting therapy and persist for at least 30 weeks after the completion of treatment.

Is Anpar safe during pregnancy?

Anpar can be used relatively safely in both oral and topical formulations during pregnancy.

Can I take Anpar during breastfeeding?

Anpar tablets are generally not recommended if you're breastfeeding. There are other antifungal medicines that are safer. Your doctor will recommend the best medicine for you.

Can I drink alcohol with Anpar?

Yes, you can drink alcohol while using or taking Anpar.

Can I drive after taking Anpar?

Some people have reported feeling dizzy or giddy while they are taking Anpar. If you feel like this, you should not drive or operate machinery.

What is the best time of day to take Anpar?

Take Anpar tablets at the same time each day, either in the morning OR in the evening.

What is the best time of day to take Anpar?

Take Anpar tablets at the same time each day, either in the morning or in the evening.You can take Anpar with or without food.

Does Anpar affect the heart?

Anpar can affect your blood cells and your liver. You may need blood tests before you start and while you are taking Anpar to check your blood cells and see how well your liver is working.

What happen If I missed Anpar?

If you forget to take your dose, take it as soon as you remember that day. If it's nearly time for your next dose, skip the missed dose and take your next dose at the usual time. Do not take 2 doses at the same time.

Will Anpar affect my fertility?

No effect of Anpar on fertility has been seen in animal studies and there are no data to suggest an effect on fertility in humans.

How long does Anpar stay in my system after stop taking Anpar ?

A terminal half-life of 200-400 hours may represent the slow elimination of Anpar from tissues such as skin and adipose.

What should I avoid while taking Anpar?

Avoid coffee, tea, cola, energy drinks or other sources of caffeine while taking Anpar.

What happens when I stop taking Anpar?

If you stop taking Anpar too soon, your symptoms may return. Anpar works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses.

Does hair grow back after Anpar?

Hair will grow back by itself once a person stops taking Anpar.

Is Anpar bad for my liver?

Some people taking Anpar have developed severe liver damage leading to liver transplant or death.

How fast does Anpar work?

Anpar is rapidly absorbed and widely distributed to body tissues including the poorly perfused nail matrix.

How long do side effects from Anpar last?

Anpar may resolve within several weeks after discontinuation of treatment, but may be prolonged,or may be permanent.

Does Anpar affect periods?

You may have problems, such as bleeding between periods, while you are taking Anpar . You may need to take different amounts of your medicines or you may need to take different medicines.