{"id":59468,"date":"2024-02-28T05:59:35","date_gmt":"2024-02-28T05:59:35","guid":{"rendered":"https:\/\/medsname.com\/terbijohn\/"},"modified":"2026-04-30T10:23:57","modified_gmt":"2026-04-30T10:23:57","slug":"terbijohn","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/terbijohn\/","title":{"rendered":"Terbijohn"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 20px;margin:18px 0;border-radius:6px;\">\n<h3 style=\"margin-top:0;\">\ud83d\udca1 Rychl\u00e1 odpov\u011b\u010f<\/h3>\n<p style=\"margin-bottom:0;\">Terbijohn is terbinafine 250 mg oral tablet \u2014 an allylamine antifungal and the <strong>l\u00e9k prvn\u00ed volby pro peror\u00e1ln\u00ed l\u00e9\u010dbu dermatofytn\u00ed onychomyk\u00f3zy (pl\u00eds\u0148ov\u00e9 infekce neht\u016f na nohou\/rukou) a tinea capitis<\/strong>. D\u00e1vkov\u00e1n\u00ed: 250 mg jednou denn\u011b po dobu 6 t\u00fddn\u016f (nehty na rukou) nebo 12 t\u00fddn\u016f (nehty na nohou). Koncentruje se v k\u016f\u017ei a nehtech \u2014 p\u0159etrv\u00e1v\u00e1 v nehtov\u00e9m l\u016f\u017eku t\u00fddny po posledn\u00ed d\u00e1vce. Dosahuje nejvy\u0161\u0161\u00ed \u00fasp\u011b\u0161nosti l\u00e9\u010dby ze v\u0161ech peror\u00e1ln\u00edch antimykotik pro dermatofytn\u00ed infekce (~76%). Vy\u017eaduje monitorov\u00e1n\u00ed jatern\u00edch funkc\u00ed; vz\u00e1cn\u011b m\u016f\u017ee zp\u016fsobit z\u00e1va\u017en\u00e9 po\u0161kozen\u00ed jater. Ne\u00fa\u010dinn\u00e9 proti kandid\u011b a nedermatofytn\u00edm kvasink\u00e1m \u2014 p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby potvr\u010fte dermatofytn\u00ed p\u016fvod infekce.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f5f5f5;border:1px solid #e1e1e1;padding:18px 22px;margin:24px 0;border-radius:8px;display:flex;flex-wrap:wrap;justify-content:space-around;gap:16px;align-items:center;font-size:0.95em;\">\n<div style=\"text-align:center;flex:1;min-width:140px;\">\ud83c\udfed<br \/><strong>WHO-GMP<\/strong><br \/>certifikovan\u00fd v\u00fdrobce<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<div style=\"text-align:center;flex:1;min-width:140px;\">\ud83d\udce6<br \/><strong>Diskr\u00e9tn\u00ed balen\u00ed<\/strong><br \/>oby\u010dejn\u00e1 ob\u00e1lka<\/div>\n<div style=\"text-align:center;flex:1;min-width:140px;\">\ud83c\udf0d<br \/><strong>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/strong><br \/>do v\u011bt\u0161iny zem\u00ed<\/div>\n<div style=\"text-align:center;flex:1;min-width:140px;\">\u2b50<br \/><strong>1 400+ z\u00e1kazn\u00edk\u016f<\/strong><br \/><a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">\u010d\u00edst recenze<\/a><\/div>\n<\/div>\n<h2>\ud83d\udd12 Why order Terbijohn from MedsBase<\/h2>\n<ul>\n<li><strong>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/strong> \u2014 dod\u00e1v\u00e1no z regulovan\u00e9ho za\u0159\u00edzen\u00ed, kompletn\u00ed balen\u00ed s \u010d\u00edslem \u0161ar\u017ee a datem expirace.<\/li>\n<li><strong>Diskr\u00e9tn\u00ed balen\u00ed<\/strong> \u2014 oby\u010dejn\u00e1 ob\u00e1lka, bez uveden\u00ed n\u00e1zvu l\u00e9ku na vn\u011bj\u0161\u00ed stran\u011b.<\/li>\n<li><strong>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/strong> do v\u011bt\u0161iny zem\u00ed s <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\">Reshipment Assurance<\/a>.<\/li>\n<li><strong>V\u011brnostn\u00ed body<\/strong> \u2014 1 bod za ka\u017ed\u00fd utracen\u00fd 1$ (neplat\u00ed pro peptidy\/dopravu); 100 bod\u016f = 5$ sleva na dal\u0161\u00ed objedn\u00e1vku.<\/li>\n<\/ul>\n<h2 id=\"uses\">Pou\u017eit\u00ed a indikace<\/h2>\n<p>Terbijohn (terbinafine 250 mg, Johnlee Pharma) is the standard oral therapy for dermatophyte fungal infections of the skin and nails. It is fungicidal against dermatophytes (Trichophyton, Epidermophyton, Microsporum), fungistatic against most Candida species (so not used for yeast infections), and active against some moulds.<\/p>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;font-size:0.95em;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">Indikace<\/th>\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">Typick\u00e9 d\u00e1vkov\u00e1n\u00ed<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Onychomyk\u00f3za \u2014 nehty na rukou<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">250 mg jednou denn\u011b po dobu 6 t\u00fddn\u016f<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Onychomyk\u00f3za \u2014 nehty na nohou<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">250 mg jednou denn\u011b po dobu 12 t\u00fddn\u016f<\/td>\n<\/tr>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Tinea capitis (pl\u00edse\u0148 vlasov\u00e9 poko\u017eky) \u2014 dosp\u011bl\u00ed<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">250 mg jednou denn\u011b po dobu 4 t\u00fddn\u016f<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Tinea capitis \u2014 d\u011bti &gt; 4 let<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">D\u00e1vkov\u00e1n\u00ed podle hmotnosti: 62,5 mg (10\u201320 kg) \/ 125 mg (20\u201340 kg) \/ 250 mg (&gt; 40 kg) jednou denn\u011b po dobu 4 t\u00fddn\u016f<\/td>\n<\/tr>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Tinea pedis \/ cruris \/ corporis (rozs\u00e1hl\u00e9 nebo refraktern\u00ed na lok\u00e1ln\u00ed l\u00e9\u010dbu)<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">250 mg jednou denn\u011b po dobu 2\u20136 t\u00fddn\u016f<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Tinea manuum<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">250 mg jednou denn\u011b po dobu 2\u20134 t\u00fddn\u016f<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 id=\"how-to-take\">Jak u\u017e\u00edvat<\/h2>\n<ul>\n<li>U\u017e\u00edvejte s j\u00eddlem nebo nala\u010dno \u2014 vst\u0159eb\u00e1v\u00e1n\u00ed nen\u00ed v\u00fdznamn\u011b ovlivn\u011bno.<\/li>\n<li>U\u017e\u00edvejte ka\u017ed\u00fd den ve stejnou dobu, aby byla zachov\u00e1na stabiln\u00ed hladina v plazm\u011b.<\/li>\n<li>Nep\u0159eru\u0161ujte l\u00e9\u010dbu p\u0159ed\u010dasn\u011b \u2014 i kdy\u017e nehet vypad\u00e1 norm\u00e1ln\u011b, dermatofyty mohou p\u0159etrv\u00e1vat hluboko v nehtov\u00e9 matrix.<\/li>\n<li>Mrtv\u00fd, houbou posti\u017een\u00fd nehet bude r\u016fst ven je\u0161t\u011b 9\u201312 m\u011bs\u00edc\u016f po \u00fasp\u011b\u0161n\u00e9m 12t\u00fddenn\u00edm l\u00e9\u010debn\u00e9m cyklu. To je norm\u00e1ln\u00ed.<\/li>\n<\/ul>\n<h2 id=\"mechanism\">Jak to funguje<\/h2>\n<p>Terbinafin inhibuje skvalen-epoxid\u00e1zu \u2014 enzym nach\u00e1zej\u00edc\u00ed se v ergosterolov\u00e9 biosyntetick\u00e9 dr\u00e1ze d\u0159\u00edve ne\u017e c\u00edl CYP51 azol\u016f. To zp\u016fsobuje hromad\u011bn\u00ed skvalenu uvnit\u0159 houbov\u00e9 bu\u0148ky (toxick\u00fd efekt) A nedostatek ergosterolu (naru\u0161en\u00ed membr\u00e1ny) \u2014 tento dvoj\u00ed mechanismus je d\u016fvodem, pro\u010d je terbinafin fungicidn\u00ed v\u016f\u010di dermatofyt\u016fm. Vysoce lipofiln\u00ed \u2014 koncentruje se v stratum corneum, vlasov\u00fdch folikulech, mazu a nehtu v koncentrac\u00edch mnohon\u00e1sobn\u011b vy\u0161\u0161\u00edch ne\u017e v plazm\u011b. V nehtu p\u0159etrv\u00e1v\u00e1 t\u00fddny po ukon\u010den\u00ed d\u00e1vkov\u00e1n\u00ed.<\/p>\n<h2 id=\"side-effects\">Ne\u017e\u00e1douc\u00ed \u00fa\u010dinky &amp; monitorov\u00e1n\u00ed<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;font-size:0.95em;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">Frekvence<\/th>\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">\u00da\u010dinky<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Velmi \u010dast\u00e9 (\u226510 %)<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Bolest hlavy, gastrointestin\u00e1ln\u00ed p\u0159\u00edznaky (nevolnost, bolesti b\u0159icha, pr\u016fjem), m\u00edrn\u00e1 vyr\u00e1\u017eka<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">B\u011b\u017en\u00e9<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\"><strong>Porucha chuti \/ ztr\u00e1ta chuti<\/strong> (~3 % \u2014 obvykle reverzibiln\u00ed b\u011bhem t\u00fddn\u016f a\u017e m\u011bs\u00edc\u016f, ale m\u016f\u017ee b\u00fdt p\u0159etrv\u00e1vaj\u00edc\u00ed), artralgie, myalgie<\/td>\n<\/tr>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">M\u00e9n\u011b \u010dast\u00e9<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Zv\u00fd\u0161en\u00ed jatern\u00edch enzym\u016f, deprese, perifern\u00ed neuropatie<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Vz\u00e1cn\u00e9, ale z\u00e1va\u017en\u00e9<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Z\u00e1va\u017en\u00e1 hepatotoxicita (idiosynkratick\u00e1, m\u016f\u017ee b\u00fdt fat\u00e1ln\u00ed \u2013 p\u0159eru\u0161te l\u00e9\u010dbu, pokud AST\/ALT &gt; 3\u00d7 ULN nebo p\u0159i jak\u00fdchkoli p\u0159\u00edznac\u00edch), z\u00e1va\u017en\u00e9 ko\u017en\u00ed reakce (SJS, TEN, AGEP), l\u00e9ky vyvolan\u00fd lupus, agranulocyt\u00f3za, neutropenie<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 20px;margin:20px 0;border-radius:6px;\"><strong>Monitorov\u00e1n\u00ed jatern\u00edch funkc\u00ed<\/strong><\/p>\n<div>P\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby zkontrolujte z\u00e1kladn\u00ed hodnoty jatern\u00edch test\u016f. Opakujte po 4\u20136 t\u00fddnech, pokud l\u00e9\u010dba trv\u00e1 d\u00e9le ne\u017e 6 t\u00fddn\u016f. Terbinafin okam\u017eit\u011b vysa\u010fte, pokud AST\/ALT &gt; 3\u00d7 ULN nebo p\u0159i p\u0159\u00edznac\u00edch (\u017eloutenka, tmav\u00e1 mo\u010d, p\u0159etrv\u00e1vaj\u00edc\u00ed nevolnost, bolest v prav\u00e9m pod\u017eeb\u0159\u00ed, siln\u00e1 \u00fanava). V\u011bt\u0161ina p\u0159\u00edpad\u016f z\u00e1va\u017en\u00e9 hepatotoxicity se vyskytne do 4\u20136 t\u00fddn\u016f od za\u010d\u00e1tku l\u00e9\u010dby.<\/div>\n<\/div>\n<h2 id=\"interactions\">Interakce l\u00e9k\u016f<\/h2>\n<p>Terbinafin m\u00e1 m\u00e9n\u011b interakc\u00ed ne\u017e azoly, ale je st\u0159edn\u00edm inhibitorem CYP2D6:<\/p>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;font-size:0.95em;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">T\u0159\u00edda l\u00e9\u010div<\/th>\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">\u00da\u010dinek<\/th>\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">\u00da\u010dinek<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Tricyklick\u00e1 antidepresiva (amitriptylin, nortriptylin)<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Hladiny stoupaj\u00ed \u2013 anticholinergn\u00ed\/kardi\u00e1ln\u00ed toxicita<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Sni\u017ete d\u00e1vku; monitorujte<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">SSRI\/SNRI (paroxetin, fluoxetin, venlafaxin, duloxetin)<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Hladiny stoupaj\u00ed<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Sledujte p\u0159\u00edznaky serotoninov\u00e9ho syndromu\/vedlej\u0161\u00edch \u00fa\u010dink\u016f<\/td>\n<\/tr>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Betablok\u00e1tory (metoprolol, propranolol, karvedilol)<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Hladiny stoupaj\u00ed \u2013 bradykardie, hypotenze<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Monitorujte puls\/krevn\u00ed tlak<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Antiarytmika (flekainid, propafenon)<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Hladiny stoupaj\u00ed \u2013 proarytmie<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Pokud mo\u017eno se kombinaci vyhn\u011bte<\/td>\n<\/tr>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Kodein, tramadol<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Sn\u00ed\u017een\u00fd analgetick\u00fd \u00fa\u010dinek (CYP2D6 tyto l\u00e1tky aktivuje)<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">P\u0159echod na morfin nebo neopioidn\u00ed analgetika<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Rifampicin<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Zv\u00fd\u0161en\u00e1 clearance terbinafinu<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Zv\u00fd\u0161it d\u00e1vku terbinafinu o 50 % nebo prodlou\u017eit dobu pod\u00e1v\u00e1n\u00ed<\/td>\n<\/tr>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Cimetidin<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Sni\u017euje clearance terbinafinu<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Obvykle nen\u00ed nutn\u00e1 zm\u011bna d\u00e1vkov\u00e1n\u00ed<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Kofein<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Hladiny stoupaj\u00ed \u2014 nervozita<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Omezit p\u0159\u00edjem kofeinu<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 id=\"contraindications\">Kdo by nem\u011bl u\u017e\u00edvat peror\u00e1ln\u00ed terbinafin<\/h2>\n<ul>\n<li>Aktivn\u00ed nebo chronick\u00e9 jatern\u00ed onemocn\u011bn\u00ed \u2014 zejm\u00e9na cirh\u00f3za, aktivn\u00ed hepatitida.<\/li>\n<li>T\u011b\u017ek\u00e9 ren\u00e1ln\u00ed posti\u017een\u00ed (CrCl &lt; 50 ml\/min \u2014 omezen\u00e9 \u00fadaje).<\/li>\n<li>P\u0159ecitliv\u011blost na terbinafin.<\/li>\n<li>Opatrnost u pacient\u016f s autoimunitn\u00edm onemocn\u011bn\u00edm \u2014 terbinafin m\u016f\u017ee vyvolat ko\u017en\u00ed lupus.<\/li>\n<li>Opatrnost v t\u011bhotenstv\u00ed a p\u0159i kojen\u00ed (omezen\u00e1 data; odlo\u017ete l\u00e9\u010dbu onychomyk\u00f3zy a\u017e po t\u011bhotenstv\u00ed).<\/li>\n<\/ul>\n<h2 id=\"pregnancy\">T\u011bhotenstv\u00ed a kojen\u00ed<\/h2>\n<p>Omezen\u00e1 data o u\u017e\u00edv\u00e1n\u00ed v t\u011bhotenstv\u00ed. Studie na zv\u00ed\u0159atech neprok\u00e1zaly teratogenitu. Onychomyk\u00f3za nen\u00ed \u017eivot ohro\u017euj\u00edc\u00ed \u2013 odlo\u017ete l\u00e9\u010dbu a\u017e po t\u011bhotenstv\u00ed a kojen\u00ed. Terbinafin se vylu\u010duje do mate\u0159sk\u00e9ho ml\u00e9ka; nedoporu\u010duje se b\u011bhem kojen\u00ed, pokud p\u0159\u00ednos jasn\u011b nep\u0159ev\u00e1\u017e\u00ed riziko.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3>Za jak dlouho bude m\u016fj nehet vypadat norm\u00e1ln\u011b?<\/h3>\n<p>L\u00e9k odstran\u00ed pl\u00edse\u0148 b\u011bhem 12t\u00fddenn\u00edho cyklu, ale mrtv\u00fd, zabarven\u00fd nehet st\u00e1le dor\u016fst\u00e1 z kutikuly. Nehty na nohou vypadaj\u00ed pln\u011b norm\u00e1ln\u011b za 9\u201312 m\u011bs\u00edc\u016f; na rukou za 4\u20136 m\u011bs\u00edc\u016f. Fotografie v m\u011bs\u00edc\u00edch 0, 3, 6, 12 pro objektivn\u00ed sledov\u00e1n\u00ed.<\/p>\n<h3>Pro\u010d mus\u00edm nejprve potvrdit, \u017ee jde o dermatofyt?<\/h3>\n<p>Terbinafin je vysoce \u00fa\u010dinn\u00fd proti dermatofyt\u016fm (Trichophyton, Epidermophyton), ale jen slab\u011b \u00fa\u010dinn\u00fd proti Candid\u011b a v\u011bt\u0161in\u011b nedermatofytn\u00edch pl\u00edsn\u00ed. ~50 % zabarven\u00ed neht\u016f nen\u00ed zp\u016fsobeno dermatofytn\u00ed pl\u00edsn\u00ed (psori\u00e1za, lichen planus, trauma, melanom). Vy\u0161et\u0159en\u00ed nehtov\u00e9ho v\u00fd\u0159ezu mikroskopi\u00ed a kultivac\u00ed (nebo PCR) p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby u\u0161et\u0159\u00ed 12 t\u00fddn\u016f zbyte\u010dn\u00e9 terapie.<\/p>\n<h3>Pro\u010d c\u00edt\u00edm kovovou chu\u0165 \/ nec\u00edt\u00edm chu\u0165 j\u00eddla?<\/h3>\n<p>Poruchy chuti postihuj\u00ed ~3 % pacient\u016f u\u017e\u00edvaj\u00edc\u00edch peror\u00e1ln\u00ed terbinafin. Mechanismus nen\u00ed pln\u011b objasn\u011bn. Obvykle jsou reverzibiln\u00ed b\u011bhem t\u00fddn\u016f a\u017e n\u011bkolika m\u011bs\u00edc\u016f po vysazen\u00ed, ale ~10 % p\u0159\u00edpad\u016f m\u016f\u017ee b\u00fdt trval\u00fdch. Pokud se porucha chuti objev\u00ed b\u011bhem l\u00e9\u010dby, zva\u017ete jej\u00ed dopad proti \u00fasp\u011b\u0161nosti l\u00e9\u010dby \u2013 n\u011bkdy stoj\u00ed za to dokon\u010dit cyklus, jindy p\u0159ej\u00edt na itrakonazol.<\/p>\n<h3>Terbinafin vs itrakonazol \u2013 kter\u00fd l\u00e9k na nehet u nohy?<\/h3>\n<p>Terbinafin je l\u00e9kem prvn\u00ed volby u dermatofytn\u00ed onychomyk\u00f3zy: vy\u0161\u0161\u00ed \u00fasp\u011b\u0161nost l\u00e9\u010dby (~76 % vs ~63 %), m\u00e9n\u011b l\u00e9kov\u00fdch interakc\u00ed, \u017e\u00e1dn\u00e9 pravidlo ohledn\u011b kysel\u00e9ho prost\u0159ed\u00ed. Itrakonazol v pulzn\u00edm re\u017eimu je preferov\u00e1n u nedermatofytn\u00edch pl\u00edsn\u00ed nebo sm\u00ed\u0161en\u00e9 Candidov\u00e9 onychomyk\u00f3zy, nebo kdy\u017e je terbinafin kontraindikov\u00e1n.<\/p>\n<h3>Mohu p\u00edt alkohol p\u0159i u\u017e\u00edv\u00e1n\u00ed terbinafinu?<\/h3>\n<p>Alkohol i terbinafin jsou metabolizov\u00e1ny v j\u00e1trech. Nadm\u011brn\u00e1 konzumace alkoholu zvy\u0161uje riziko hepatotoxicity. M\u00edrn\u00e1 konzumace je obecn\u011b p\u0159ijateln\u00e1; vyhn\u011bte se n\u00e1razov\u00e9mu pit\u00ed a alkohol zcela vynechte, pokud m\u00e1te jak\u00e9koli p\u0159edchoz\u00ed jatern\u00ed pot\u00ed\u017ee. 12t\u00fddenn\u00ed l\u00e9\u010dba je rozumnou dobou pro sn\u00ed\u017een\u00ed p\u0159\u00edjmu alkoholu.<\/p>\n<h3>A co m\u00e9 d\u00edt\u011b s pl\u00eds\u0148ov\u00fdm onemocn\u011bn\u00edm poko\u017eky hlavy?<\/h3>\n<p>Terbinafin je schv\u00e1len pro l\u00e9\u010dbu tinea capitis u d\u011bt\u00ed star\u0161\u00edch 4 let (d\u00e1vkov\u00e1n\u00ed podle hmotnosti). U Trichophyton tonsurans (b\u011b\u017en\u00e9ho p\u016fvodce v UK\/US) je l\u00e9kem prvn\u00ed volby \u2014 4t\u00fddenn\u00ed l\u00e9\u010dba, vy\u0161\u0161\u00ed \u00fasp\u011b\u0161nost l\u00e9\u010dby ne\u017e u griseofulvinu a krat\u0161\u00ed doba l\u00e9\u010dby. U Microsporum canis je preferov\u00e1n griseofulvin.<\/p>\n<h3>M\u011bl(a) jsem v minulosti alopecia areata \u2014 m\u016f\u017ee terbinafin stav zhor\u0161it?<\/h3>\n<p>Terbinafin je jen z\u0159\u00eddka spojov\u00e1n s nov\u011b vzniklou ztr\u00e1tou vlas\u016f (telogenn\u00ed effluvium). P\u0159edchoz\u00ed alopecia areata nen\u00ed kontraindikac\u00ed. Pokud dojde k v\u00fdrazn\u00e9 ztr\u00e1t\u011b vlas\u016f, konzultujte s dermatologem.<\/p>\n<h3>Pro\u010d m\u011b bol\u00ed svaly p\u0159i u\u017e\u00edv\u00e1n\u00ed terbinafinu?<\/h3>\n<p>Myalgie a artralgie jsou zn\u00e1m\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky (~5%). Obvykle jsou m\u00edrn\u00e9 a ustoup\u00ed p\u0159i pokra\u010dov\u00e1n\u00ed l\u00e9\u010dby. P\u0159i siln\u00e9 bolesti sval\u016f, tmav\u00e9 mo\u010di nebo slabosti \u2014 p\u0159eru\u0161te l\u00e9\u010dbu a vyhledejte l\u00e9ka\u0159skou pomoc (vz\u00e1cn\u011b rhabdomyol\u00fdza nebo l\u00e9ky indukovan\u00e1 myopatie).<\/p>\n<h3>Mohu cvi\u010dit p\u0159i u\u017e\u00edv\u00e1n\u00ed terbinafinu?<\/h3>\n<p>Ano \u2014 b\u011b\u017en\u00e9 cvi\u010den\u00ed je v po\u0159\u00e1dku. M\u00edrn\u00e1 myalgie, kterou n\u011bkte\u0159\u00ed pacienti poci\u0165uj\u00ed, nesouvis\u00ed s cvi\u010den\u00edm. Pokud se po cvi\u010den\u00ed objev\u00ed neobvykl\u00e1 bolest nohou nebo tmav\u00e1 mo\u010d, p\u0159eru\u0161te l\u00e9\u010dbu a nechte si zm\u011b\u0159it hladinu CK.<\/p>\n<h3>Is Terbijohn the same as Lamisil?<\/h3>\n<p>Yes \u2014 Lamisil is the original Novartis brand of terbinafine. Terbijohn contains the same active ingredient, manufactured by Johnlee Pharma under WHO-GMP. Bioequivalent.<\/p>\n<h2 id=\"storage\">Skladov\u00e1n\u00ed<\/h2>\n<p>Tablety skladujte p\u0159i teplot\u011b 15\u201330 \u00b0C, mimo dosah vlhkosti a sv\u011btla. Uchov\u00e1vejte v p\u016fvodn\u00edm blistru. Nepou\u017e\u00edvejte po uplynut\u00ed doby pou\u017eitelnosti. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Dal\u0161\u00ed antifung\u00e1ln\u00ed l\u00e9ky, kter\u00e9 by v\u00e1s mohly zaj\u00edmat<\/h2>\n<p>If Terbijohn is unavailable, here are alternatives \u2014 same molecule from a different manufacturer, plus options for indications where terbinafine is not first-line.<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zimig\/\"><strong>Zimig (terbinafin 250 mg)<\/strong><\/a> \u2014 L\u00e9\u010dba prvn\u00ed volby u dermatofytn\u00ed onychomyk\u00f3zy; \u00fasp\u011b\u0161nost l\u00e9\u010dby ~76 %.<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/sporanox-capsule\/\"><strong>Sporanox (itraconazol 100 mg)<\/strong><\/a> \u2014 Pulzn\u00ed terapie pro nedermatofytn\u00ed pl\u00eds\u0148ov\u00e9 nebo sm\u00ed\u0161en\u00e9 kandidov\u00e9 onychomyk\u00f3zy.<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/grisovin-fp\/\"><strong>Grisovin FP (griseofulvin)<\/strong><\/a> \u2014 Tinea capitis zp\u016fsoben\u00e1 Microsporum (pediatrick\u00e9 pou\u017eit\u00ed).<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/loceryl-nail-liq\/\"><strong>Loceryl (amorolfin 5%)<\/strong><\/a> \u2014 Top\u00e1ln\u00ed lak pro m\u00edrn\u00e9 pl\u00eds\u0148ov\u00e9 infekce dist\u00e1ln\u00edho okraje nehtu.<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zocon\/\"><strong>Zocon (fluconazol 150 mg)<\/strong><\/a> \u2014 Standardn\u00ed peror\u00e1ln\u00ed terapie pro kandid\u00f3zu (vagin\u00e1ln\u00ed, or\u00e1ln\u00ed, j\u00edcnovou formu).<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 18px;margin:24px 0;font-size:0.95em;\"><strong>Zdravotn\u00ed prohl\u00e1\u0161en\u00ed.<\/strong> Tato str\u00e1nka obsahuje informace o produktu pro dosp\u011bl\u00e9, kte\u0159\u00ed si objedn\u00e1vaj\u00ed antifung\u00e1ln\u00ed l\u00e9ky pro osobn\u00ed pot\u0159ebu. Nenahrazuje individu\u00e1ln\u00ed l\u00e9ka\u0159skou radu. Proberte vhodn\u00e9 antifung\u00e1ln\u00ed l\u00e9\u010divo, d\u00e1vkov\u00e1n\u00ed a d\u00e9lku l\u00e9\u010dby s kvalifikovan\u00fdm l\u00e9ka\u0159em \u2013 zejm\u00e9na pokud m\u00e1te onemocn\u011bn\u00ed jater, jste t\u011bhotn\u00e1 nebo koj\u00edte, u\u017e\u00edv\u00e1te warfarin, statiny, imunosupresiva nebo m\u00e1te pl\u00eds\u0148ovou infekci neht\u016f, kter\u00e1 m\u016f\u017ee b\u00fdt jinou diagn\u00f3zou (psori\u00e1za, lichen planus, trauma).<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>\u2705 Combats fungal infections<br \/>\n\u2705 Soothes itching and irritation<br \/>\n\u2705 Improves nail health<br \/>\n\u2705 Treats athlete&#8217;s foot<br \/>\n\u2705 Clears skin disorders<\/p>\n<p>Terbijohn contains Terbinafine.<\/p>","protected":false},"featured_media":59469,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3501,3141,3504,3342],"product_tag":[4701,3629],"class_list":{"0":"post-59468","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-anti-fungal","7":"product_cat-category-overview","8":"product_cat-fungal-infection-treatment","9":"product_cat-general-health","10":"product_tag-terbijohn","11":"product_tag-terbinafine","13":"first","14":"instock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/59468","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=59468"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/59469"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=59468"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=59468"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=59468"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=59468"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}