Terbinafine Caffeine

Drugs that may interact with terbinafine include the following Cimetidine, rifampin, terfenadine, caffeine, dextromethorphan, cyclosporine. 

In a randomized crossover study in 12 healthy volunteers, terbinafine increased the AUC of theophylhne by 16%, with a 14% reduction in clearance and a 24% prolongation of half-life (82). The clinical impact of these results is difficult to define because of the small sample size in this study and because it is not known what effect terbinafine has on steady-state theophylhne concentrations. An earlier study (83) showed that terbinafine reduced the clearance of caffeine, which is metabolized via similar pathways. Until more information is available, clinicians who prescribe terbinafine for patients taking chronic theophylhne therapy should be cautious, and serum theophylhne concentrations should be monitored. 

Wahllander A, Paumgartner G. Effect of ketoconazole and terbinafine on the pharmacokinetics of caffeine in healthy volunteers. Eur I Clin Pharmacol 1989 37(3) 279-83. 

Clinically important, potentially hazardous interactions with acetylcysteine, adenosine, aprepitant, aripiprazole, buprenorphine, caffeine, charcoal, clarithromycin, clobazam, dorazepate, clozapine, darunavir, dasatinib, delavirdine, dexamethasone, diltiazem, doxacurium, erythromycin, felodipine, fesoterodine, fosamprenavir, imatinib, influenza vaccines, lacosamide, lapatinib, levetiracetam, lopinavir, methylprednisolone, midazolam, nelfinavir, nilotinib, piracetam, prednisolone, propoxyphene, ritonavir, rivaroxaban, rufinamide, solifenacin, St John s wort, telithromycin, temsirolimus, terbinafine, tolvaptan, troleandomycin, verapamil, voriconazole... 

Fluconazole and terbinafine cause a modest rise in serum caffeine levels. Ketoconazole appears to have less effect. 

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