Fungal infections are common, and they can affect just about any part of your body.
If you think you may have a fungal infection, you have a number of treatment options. This article compares two popular antifungal treatments: miconazole nitrate and terbinafine.
We’ll explore what each medication is used for, how effective they are, how readily available they are, and what their safety profiles look like. We’ll also compare prescription requirements, user ratings, side effects, and potential drug interactions when considering miconazole nitrate vs terbinafine.
What are miconazole nitrate and terbinafine?
Both miconazole nitrate and terbinafine are antifungal medications. They treat different types of fungal infections in different ways.
Miconazole nitrate
Miconazole nitrate treats skin and vaginal yeast infections, athlete’s foot, jock itch, and ringworm. It comes in creams, lotions, and suppositories.
Terbinafine
Terbinafine treats nail fungus and scalp ringworm as well as other tinea infections. It is available as a topical cream or gel or in oral tablets.
Availability: Prescription vs. Over-the-Counter
You can find miconazole nitrate both over-the-counter (OTC) and with a prescription from your doctor. The OTC availability makes it easy to get for common fungal infections such as athlete’s foot or vaginal yeast infections.
Terbinafine, on the other hand, typically requires a prescription. This allows your doctor to evaluate your condition and monitor your progress, especially if you’re taking an oral medication or have a severe infection.
Efficacy and user ratings
When considering medication, it’s useful to see what others have experienced.
Miconazole nitrate ratings
Miconazole nitrate has an average rating of 3.1 out of 10, based on more than 4,000 ratings. Sixteen percent of reviewers had a positive experience, while 70 percent had a negative experience.
The high number of ratings suggests miconazole nitrate is widely used, but the ratings also indicate a great number of people have had a negative experience with it.
Terbinafine ratings
Topical terbinafine has an average rating of 6.5 out of 10, based on just 16 ratings. Sixty percent of reviewers had a positive experience, while 40 percent had a negative experience.
Oral terbinafine has an average rating of 6.4 out of 10, based on almost 500 ratings. Just over half of reviewers had a positive experience, while almost a third had negative experiences.
Safety and Side Effects
Both miconazole nitrate and terbinafine are generally considered safe when used as directed, but it’s a good idea to know about potential side effects and drug interactions.
Miconazole nitrate
- Common side effects may include irritation, burning, itching, and redness where you put the medicine.
- Drug interactions are relatively few.
- The pregnancy category is not available.
Terbinafine
- Common side effects from oral terbinafine can include headache, gastrointestinal issues, and elevated liver enzymes.
- Drug interactions are more numerous.
- The pregnancy category is B, meaning animal studies haven’t shown a risk to the fetus, but there aren’t adequate and well-controlled studies in pregnant women.
- Terbinafine has a long half-life of 200 hours, meaning it takes a long time for the drug to leave your system.
Important considerations
Here are a few things to remember when considering miconazole nitrate and terbinafine:
Drug interactions
Especially with terbinafine, it’s important to remember that drug interactions are possible. Be sure to tell your doctor about all the medications you’re taking, including over-the-counter medicines.
Pregnancy and breastfeeding
If you’re pregnant or breastfeeding, talk with your doctor before using either of these medications. Terbinafine is a Category B drug, while miconazole topical is not rated.
Liver function
Oral terbinafine can sometimes affect liver function, so your doctor may want to keep an eye on your liver while you’re taking it. If you have liver problems, you should use oral terbinafine with caution.
Frequently Asked Questions
What works better than terbinafine?
Whether something works “better” than terbinafine depends on the specific fungal infection. For some infections, oral antifungal medications (like itraconazole or fluconazole) might be more effective, but they come with a higher risk of side effects. For localized skin infections, other topical antifungals could be just as effective, depending on the fungus involved. A doctor can help determine the best treatment for your specific situation.
Which is more effective, terbinafine or miconazole?
Terbinafine and miconazole work differently and are often used for different types of fungal infections. Terbinafine is a broad-spectrum antifungal that is often prescribed for nail and skin infections caused by dermatophytes. Miconazole is typically used for yeast infections, such as athlete’s foot, jock itch, and vaginal yeast infections. Generally, terbinafine is considered more potent against dermatophytes than miconazole.
Is terbinafine the strongest antifungal?
Terbinafine is a potent antifungal, but it’s not necessarily the “strongest” for all types of fungal infections. Other antifungals, particularly those taken orally, may have a broader spectrum of activity or be more effective against specific resistant fungi. The most appropriate antifungal depends on the type and severity of the infection.
Can I use miconazole and terbinafine together?
Using miconazole and terbinafine together is generally not recommended without consulting a doctor. Since they work through different mechanisms, there’s a chance they could interfere with each other’s effectiveness or increase the risk of side effects. A healthcare professional can best advise on the most appropriate and safe treatment plan for your infection.
Closing Thoughts
Miconazole is available over the counter and has fewer drug interactions, while terbinafine usually requires a prescription and has a broader range of activity and a longer half-life.
The best choice depends on the type and severity of your fungal infection, along with your specific health needs. Talk with your doctor or other healthcare professional to get a diagnosis and find out which treatment is right for you.
Both drugs are available as generics, so they’re both relatively affordable.