Do you routinely do laboratory monitoring when prescribing terbinafine for your patients with onychomycosis?
Almost half (48%) of dermatologists monitor laboratory test results in onychomycosis patients taking terbinafine at both baseline and during therapy. Twenty-three percent monitor at baseline only; 14% at baseline and after therapy; 5% at baseline, during therapy, and after therapy; and 10% don’t monitor at all.
Expert Commentary
Provided by Shari R. Lipner, MD, PhD (New York, New York)
Almost half of board members perform laboratory monitoring for patients taking terbinafine, which was reasonable prior to any published data on blood count and liver function tests in patients taking this drug. However, a new study on this topic should make us reconsider our practices. This study analyzed the rate of laboratory test abnormalities in 4985 patients taking terbinafine or griseofulvin for dermatophyte infections. Elevated alanine aminotransferase, aspartate aminotransferase, anemia, lymphopenia, and neutropenia were uncommon and similar to the baseline rates. Therefore, routine interval laboratory monitoring may be unnecessary in healthy patients taking oral terbinafine for onychomycosis (Stolmeier et al).
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