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Lamisil vs Sporanox
Introduction
For patients suffering from fungal infections, drugs that inhibit the growth of fungus in the body are often prescribed. Lamisil and Sporanox are two such antifungal medications. They each affect different elements within the fungal cell, but both have fungicidal effects in patients with fungal infections. Lamisil is a broad-spectrum antifungal agent known as an allylamine; it works by inhibiting squalene epoxidase, an important enzyme in the biosynthesis of sterols (mainly ergosterol) needed for fungal cell membrane synthesis. On the other hand, Sporanox belongs to a class of drugs called triazoles and acts by inhibiting another enzyme, cytochrome P-450 14α-demethylase; this disrupts ergosterol synthesis at a later stage compared to Lamisil, leading to holes in the fungal cell membrane.
Lamisil vs Sporanox Side By Side
| Attribute | Lamisil | Sporanox |
|---|---|---|
| Brand Name | Lamisil | Sporanox |
| Contraindications | May exacerbate liver problems. Should not be taken with certain types of drugs like beta-blockers, calcium channel blockers, or SSRIs. | May exacerbate liver problems. Should not be taken with certain types of drugs like beta-blockers, calcium channel blockers, or SSRIs. |
| Cost | For brand name, around $500 for 30 tablets (250 mg). For generic, approximately $10-$50 for 30 up to 90 tablets. | For brand name, approximately $320 for 15 capsules (100 mg). For generic, about $20–$120 for 15 up to 60 capsules. |
| Generic Name | Terbinafine | Itraconazole |
| Most Serious Side Effect | Liver damage, severe skin reactions, changes in mood or behavior, blood issues. | Heart failure, liver problems, nervous system issues, pancreatitis. |
| Severe Drug Interactions | Beta-blockers, calcium channel blockers, SSRIs. | Beta-blockers, calcium channel blockers, SSRIs. |
| Typical Dose | 250 mg/day for adults. For children under 20 kg, 62.5 mg/day; 20 to 40 kg, 125 mg/day. | 200 mg/day, can be increased to 400 mg/day or a maximum of 600 mg/day under medical supervision. |
What is Lamisil?
Terbinafine (the generic name for Lamisil) is an antifungal medication that was a significant advance over the first class of antifungal drugs, such as griseofulvin. Terbinafine received FDA approval in 1996. It works by inhibiting a specific enzyme necessary for the growth of fungal cells, thereby stopping the infection from spreading and allowing new, healthy skin or nail to grow back. It is prescribed primarily for treating fungal infections of the skin and nails. On the other hand, Itraconazole (generic name for Sporanox), another potent antifungal drug approved later than terbinafine in 1992, has a broader spectrum of activity against various types of fungi but may have more potential side effects due to its extensive interaction with other medications metabolized in the liver. Both these drugs are effective but should be chosen based on individual patient needs and potential drug interactions.
What conditions is Lamisil approved to treat?
Lamisil is approved for the treatment of different kinds of fungal infections:
- Onychomycosis, also known as toenail or fingernail fungus
- Tinea capitis (ringworm on the scalp)
- Tinea pedis (athlete's foot), tinea cruris (jock itch) and tinea corporis (ringworm on the body) in patients over 12 years old.
Sporanox, on the other hand, is used to treat:
- Severe fungal infections throughout your body including throat, mouth, lungs, and esophagus
- Onychomycosis
How does Lamisil help with these illnesses?
Lamisil is designed to treat fungal infections by inhibiting the enzyme squalene epoxidase, which is necessary for the cell membrane structure of fungi. By disrupting this crucial part of the cellular process, Lamisil hinders fungal growth and facilitates clearing up the infection. Similarly, Sporanox works as an antifungal medication but does so by interacting with another component of fungus: it binds to a chemical called ergosterol found in fungal cell membranes. This binding prevents normal functioning and leads to a build-up of harmful substances within the cells, ultimately killing off the fungus. Both drugs are useful in managing various types of fungal infections; however, their efficacy may vary depending on specifics like type and location of infection or individual patient response.
What is Sporanox?
Sporanox, the brand name for itraconazole, is an antifungal medication that prevents fungus from growing on your skin. It primarily works by inhibiting the synthesis of ergosterol, a critical component of fungal cell membranes. This disruption in production causes increased permeability and leakage of cellular components leading to fungal cell death.
Sporanox was first approved by the FDA in 1992 and has seen widespread use since then due to its broad-spectrum activity against many fungi. Unlike Lamisil (Terbinafine), Sporanox does not only inhibit squalene epoxidase but affects various stages in the biosynthesis of ergosterol.
Its side-effect profile is also different than that of terbinafine class medications like Lamisil; common side effects with Sporanox can include nausea, diarrhea, rash or even potential liver damage which necessitates regular monitoring. Nonetheless, it's particularly effective for systemic infections - conditions where fungi have invaded tissues below the skin or spread via blood circulation – especially when patients do not respond well to other types of antifungal drugs such as Terbinafine.
What conditions is Sporanox approved to treat?
Sporanox is a widely recognized antifungal medication that has been approved for the treatment of various fungal conditions, such as:
- Onychomycosis, a type of nail fungus
- Oral and esophageal candidiasis, commonly known as thrush
- Systemic mycoses, which are serious infections caused by fungi often affecting multiple systems within the body.
How does Sporanox help with these illnesses?
Sporanox, like Lamisil, is an antifungal medication that combats infections caused by fungus. It operates in the body by inhibiting a critical component of fungal cell membranes called ergosterol; this interruption in production leads to increased cellular permeability causing leakage and eventual death of the fungus. Its broad-spectrum action implies it can fight off various types of fungi including those responsible for nail infections, skin infections and systemic infections such as blastomycosis or histoplasmosis. This makes Sporanox particularly useful when a patient does not respond well to other antifungals like Lamisil which primarily target dermatophytes responsible for skin and nail infections. Also, its pharmacological properties allow it to be combined with other treatments enhancing efficacy against stubborn fungal conditions.
How effective are both Lamisil and Sporanox?
Both terbinafine (Lamisil) and itraconazole (Sporanox) have well-established records in treating fungal infections, specifically onychomycosis -- a common nail fungus. They were approved by the FDA within three years of each other and work differently to combat fungal pathogens, so they may be prescribed under varying circumstances.
A double-blind clinical trial conducted in 2000 directly compared Lamisil and Sporanox for their effectiveness against toenail onychomycosis. The results showed that both drugs exhibited similar safety profiles but differed markedly in efficacy; Lamisil was found to be significantly more effective than Sporanox at completely clearing the infection. Furthermore, patients treated with Lamisil had fewer relapses post-treatment compared to those treated with Sporanox.
A comprehensive review in 2002 highlighted that terbinafine works faster and is better tolerated than many other antifungals due to its unique mechanism of action - inhibiting an enzyme crucial for fungal cell membrane synthesis. It's commonly prescribed as a first-line treatment option owing to its high cure rates and low recurrence rate after completion of therapy.
Itraconazole provides broad-spectrum coverage against various fungi due to its distinct pharmacologic property: blocking the synthesis pathway different from terbinafine's target. However, itraconazole is generally considered as a second-line treatment option behind terbinafine because it requires longer duration of treatment and has higher chances of side effects like gastrointestinal problems or potential interactions with other medications.
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At what dose is Lamisil typically prescribed?
Oral dosages of Lamisil range from 250 mg/day for adults, and it's generally effective in treating most cases of fungal infections. For children weighing less than 20 kg, a dose of 62.5 mg/day is recommended; those weighing between 20 to 40 kg require a dosage of up to 125 mg/day. If there is no improvement seen within a few weeks, consult with your healthcare professional before adjusting the dosage. It’s important to note that exceeding the maximum daily dosage could lead to severe side effects and complications.
At what dose is Sporanox typically prescribed?
Sporanox treatment typically begins at a dosage of 200 mg/day, split into two doses taken roughly 12 hours apart. If necessary, the dose can be increased to 400 mg/day, divided into two doses spaced evenly throughout the day. In some cases where there is no response to initial treatment after several weeks, a maximum dose of up to 600 mg per day may be considered under medical supervision. This would involve three doses of 200 mg each spread out over the course of the day with intervals of approximately eight hours between each one.
What are the most common side effects for Lamisil?
Common side effects of Lamisil and Sporanox can vary based on the individual, but here are some potential ones to be aware of:
- Headache
- Dizziness or light-headedness
- Upset stomach (nausea)
- Diarrhea
- Changes in your sense of taste or smell
- Rash, itching, hives
- Fatigue (general weakness)
- Unexplained fever
- Abdominal pain -Loss of appetite -Jaundice (yellowing skin and eyes)
Remember always to consult with your healthcare provider if you experience any adverse reactions while taking these medications.
Are there any potential serious side effects for Lamisil?
In rare instances, Lamisil may cause serious side effects including:
- Signs of an allergic reaction: hives; difficulty breathing; swelling in your face or throat
- Severe skin reaction: fever, sore throat, burning eyes, skin pain with red/purple rash that spreads especially to the face or upper body causing blistering and peeling
- Symptoms related to liver damage: nausea, upper stomach pain, itching/tiredness/loss of appetite/dark urine/clay-colored stools/jaundice (yellowing of the skin or eyes)
- Unusual changes in mood or behavior: depression/anxiety/agitation/sleep problems/confusion/hallucinations
- Symptoms related to blood issues: pale skin/light-headed feeling/unusual tiredness/new onset infections/easy bruising/unexplained bleeding (nose/gum/vagina/rectum)/purple/red pinpoint spots under your skin
If you experience any of these symptoms while taking Lamisil, seek immediate medical attention. On the other hand, Sporanox can also have severe side effects but they are more associated with heart failure and lung disease. Always consult a healthcare professional before starting a new medication.
What are the most common side effects for Sporanox?
Sporanox, like Lamisil, is used to treat fungal infections. However, the side effects of Sporanox can include:
- Nausea, vomiting or stomach discomfort
- Diarrhea or constipation
- Mild skin itching or rash
- Headache or dizziness
- Unusual tiredness
- Changes in your sense of taste
- Swelling in your hands or feet.
It's important to note that while these are some common side effects associated with Sporanox usage, not all patients will experience them and they may be more mild than those listed above. If you're starting a new medication like Sporanox and notice any changes in how you feel physically or mentally, it's always best to consult with a healthcare professional right away.
Are there any potential serious side effects for Sporanox?
While Sporanox is an effective medication for treating various fungal infections, it can sometimes cause serious side effects. Be alert to the following symptoms:
- Signs of a severe allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Heart failure symptoms: sudden weight gain, feeling short of breath even with mild exertion or while lying down
- Liver problems signs: nausea, upper stomach pain, itching, tiredness, loss of appetite and jaundice (yellowing of the skin or eyes)
- Nervous system issues such as hearing loss or ringing in your ears
- Symptoms related to pancreatitis like severe pain in your upper stomach spreading to your back and vomiting
If you experience any one or more of these symptoms after starting Sporanox treatment stop using this drug immediately and seek medical attention.
Contraindications for Lamisil and Sporanox?
Both Lamisil and Sporanox, as with most other antifungal medications, may exacerbate liver problems in some people. If you notice symptoms such as persistent nausea, loss of appetite, severe stomach/abdominal pain, yellowing eyes/skin or dark urine while taking these medications, please seek immediate medical attention.
Neither Lamisil nor Sporanox should be taken if you are currently on certain types of drugs like beta-blockers (used for heart conditions), calcium channel blockers (for high blood pressure/heart conditions) or SSRIs (antidepressants). Always inform your physician about all the medications you are taking; these classes of drugs will require careful observation and potential dosage adjustments to prevent dangerous interactions with both Lamisil and Sporanox.
How much do Lamisil and Sporanox cost?
For the brand name versions of these antifungal drugs:
- The price for 30 tablets of Lamisil (250 mg) averages around $500, which works out to about $16.67 per day.
- The price for 15 capsules of Sporanox (100 mg) is approximately $320, meaning around $21.33 per day.
Thus, if you are taking one tablet or capsule per day as it's usually recommended for fungal infections treatment, then brand-name Lamisil is less expensive on a daily basis compared to Sporanox. Please remember that cost should not be your only consideration in determining which medication would best suit your needs.
When considering the generic versions of these medications - terbinafine (Lamisil) and itraconazole (Sporanox), costs are substantially lower:
- Terbinafine is available in packs from 30 up to 90 tablets with approximate costs ranging from about $10-$50 total depending on the pharmacy and location; this equates to roughly $0.11–$1.66/day.
- Itraconazole typically comes in packs from 15 up to 60 capsules with prices varying broadly but often falling within a range of about $20–$120 total; that translates into approximately a daily cost between $0.33 and $8/day.
In general terms, terbinafine tends to be more affordable than itraconazole whether comparing branded or generic forms of each drug.
Popularity of Lamisil and Sporanox
Terbinafine, commonly known by the brand name Lamisil, and Itraconazole, often marketed as Sporanox, are two antifungal medications frequently used in the treatment of fungal nail infections. They both inhibit the synthesis of ergosterol, a key component of fungal cell membranes.
In 2020, Terbinafine was prescribed to approximately 3.5 million patients in the United States. Accounting for nearly 60% of prescriptions for oral antifungal treatments against onychomycosis (fungal nail infection), Terbinafine has seen a steady increase in usage over recent years due to its high efficacy rate and relatively lower side effect profile compared to other treatments.
Itraconazole was prescribed to about 1.2 million people during that same year. This medication holds roughly a fifth of total prescriptions for this type of infection treatment. The use of itraconazole has remained stable over the past decade with minor fluctuations likely attributed to individual patient needs and contraindications such as potential drug interactions or pre-existing liver conditions.
Conclusion
Both Lamisil (terbinafine) and Sporanox (itraconazole) have a long-standing record of usage in patients with fungal infections. They are backed by numerous clinical studies that indicate they are more effective than placebo treatments. Both operate through different mechanisms of action, with Lamisil inhibiting the enzyme squalene epoxidase, leading to ergosterol deficiency and an accumulation of squalene within the fungal cell leading to cell death, while Sporanox operates primarily by interfering with the synthesis of ergosterol for cellular membranes.
Lamisil is often considered as a first-line treatment option for onychomycosis because it offers complete cure rates higher than those offered by Sporanox. However, Sporanox may be preferred in cases where there's mucosal candidal infections or systemic mycoses which do not respond well to other antifungal agents.
Both drugs are available in generic form, representing significant cost savings especially for patients who must pay out-of-pocket. Both Lamisil and Sporanox may require a couple weeks before effects become noticeable due their nature aiming at promoting healthy nail growth which takes time.
The side effect profile is similar between these two drugs, both being usually well-tolerated but can cause problems such as liver damage or heart failure if not used properly. For both drugs, patients should closely monitor their health status when starting treatment and seek medical help immediately if they notice symptoms worsening or any signs indicative of liver damage such as jaundice.
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Refrences
- DEL PALACIO HERNANZ, A., LOPEZ GOMEZ, S., GONZALEZ LASTRA, F., MORENO PALANCAR, P., & IGLESIAS DIEZ, L. (1990, May). A comparative double-blind study of terbinafine (Lamisil) and griseofulvin in tinea corporis and tinea cruris. Clinical and Experimental Dermatology. Oxford University Press (OUP).http://doi.org/10.1111/j.1365-2230.1990.tb02074.x
- RYDER, N. S. (1992, February). Terbinafine: Mode of action and properties of the squalene epoxidase inhibition. British Journal of Dermatology. Oxford University Press (OUP).http://doi.org/10.1111/j.1365-2133.1992.tb00001.x
- Evans, E. G. V., & Sigurgeirsson, B. (1999, April 17). Double blind, randomised study of continuous terbinafine compared with intermittent itraconazole in treatment of toenail onychomycosis. Bmj. BMJ.http://doi.org/10.1136/bmj.318.7190.1031
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- Caputo, R. (2003, December). Itraconazole (Sporanox®) in superficial and systemic fungal infections. Expert Review of Anti-infective Therapy. Informa UK Limited.http://doi.org/10.1586/14787210.1.4.531
- DE BACKER, M., DE KEYSER, P., DE VROEY, C., & LESAFFRE, E. (1996, June). A 12-week treatment for dermatophyte toe onychomycosis terbinafine 250mg/day vs. itraconazole 200mg/day-a double-blind comparative trial. British Journal of Dermatology. Oxford University Press (OUP).http://doi.org/10.1111/j.1365-2133.1996.tb15653.x
- Roberts. (1999, November). Onychomycosis: current treatment and future challenges. British Journal of Dermatology. Oxford University Press (OUP).http://doi.org/10.1046/j.1365-2133.1999.00007.x