What is a major side effect of terbinafine that healthcare providers should be aware of?

Hepatotoxicity is a significant concern associated with the use of terbinafine, particularly in patients with pre-existing liver conditions or those taking other medications that can impact liver function. Terbinafine is an antifungal agent that works by inhibiting squalene epoxidase, an important enzyme in the ergosterol synthesis pathway of fungi. While it is generally well-tolerated, some patients may develop liver enzyme abnormalities, jaundice, or even serious liver injury, which necessitates monitoring liver function during treatment. Healthcare providers often recommend baseline liver function tests before starting terbinafine, as well as periodic monitoring, particularly for those on long-term therapy or with risk factors for liver disease.

Other potential side effects include gastrointestinal distress and neuropathies; however, these are generally less significant compared to the risk of hepatotoxicity. Kidney damage is not typically a primary concern with terbinafine, making hepatotoxicity the foremost side effect that healthcare providers should remain vigilant about during treatment.