Effect of oral terbinafine treatment on cyclosporin pharmacokinetics in organ transplant recipients with dermatophyte nail infection.

Eleven patients with either kidney, heart or lung transplants, immunosuppressed with cyclosporin A, and with culture-proven dermatophyte toe nail infection, were given 250 mg terbinafine orally daily for 12 weeks. No changes in cyclosporin A dosage were made. A statistically significant decrease in mean specific cyclosporin A blood trough levels was found at 4, 8 and 12 weeks. No other statistically significant changes in the pharmacokinetic profile of cyclosporin A were seen. Terbinafine possibly induces a cyclosporin A metabolic degradation, which, however, is of little clinical significance. Terbinafine treatment is a safe therapeutical option in cyclosporin A-treated patients with dermatophyte nail infection. Cyclosporin A levels should be controlled during treatment.