Elvina 250

Introduction
Elvina 250 is used to treat a wide range of fungal infections of the skin and nails, including ringworm. It works by killing the fungus that causes the infection. Elvina 250 is for external use only. It should be used in the dose and duration suggested by the doctor. Applying it at the same time every day will help you remember to use it. The affected area should be clean and dry before application of the ointment. You must wash your hands thoroughly before and after applying this medicine. Do not stop using it until you have finished the complete course, even when you feel better. If you stop using this medicine too early, the fungus may continue to grow and the infection may return or worsen. The most common side effects of this medicine include application site reactions like burning, irritation, itching, and redness. These are usually mild but let your doctor know if they bother you or last more than a few days. Avoid direct contact with eyes, nose, or mouth. If accidental exposure occurs, rinse immediately with plenty of water. You must inform your doctor if there’s no improvement even after four weeks of treatment. It is not likely that other medicines you take by mouth or injection will affect the way it works but talk to your doctor before using it if you have used a similar medicine before and had an allergic reaction. Pregnant and breastfeeding mothers should consult their doctor before using it.

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Uses of Elvina 250
Fungal skin infections
Side effects of Elvina 250
Common
Skin peeling
How to use Elvina 250
This medicine is for external use only. Use it in the dose and duration as advised by your doctor. Check the label for directions before use. Clean and dry the affected area and apply the cream. Wash your hands after applying, unless hands are the affected area.
How Elvina 250 works
Elvina 250 is an antifungal medication which treats skin infections. It works by killing the fungi on the skin by destroying their cell membrane.
What if you forget to take Elvina 250?
If you miss a dose of Elvina 250, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
Elvina 250 helps treat skin infections caused by many different types of fungi.
Finish the full course of treatment even if you feel better.
It can take a few weeks for the infection to clear and a few months before the skin returns to its normal color.
Apply an amount sufficient to cover the affected area and 1 inch of the immediate surrounding skin.
It can make your skin more sensitive to sun. Use broad-spectrum sunscreen and protective clothing when outdoors.
Avoid getting in the eyes, nose, or mouth. If accidental exposure occurs, rinse immediately with plenty of water.
Inform your doctor if the infection has not cleared up after four weeks of treatment.
Brief Description
Indication
Tinea pedis, Tinea cruris, Tinea corporis, Dermatophytosis, Nail infections
Administration
May be taken with or without food.
Adult Dose
Oral Onychomycosis Adult: 250 mg once daily for 6 weeks (fingernail) or 12 weeks (toenail) Tinea Pedis, Tinea Corporis, Tinea Cruris Adult: 250 mg/day PO in single dose or divided q12hr 2-4 wk in tinea cruris, tinea corporis 2-6 wk for tinea pedis Hepatic impairment: Use not recommended in chronic or active liver disease

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Child Dose
Tinea Capitis >4 years (<25 kg): 125 mg/day PO for 6 weeks >4 years (25-35 kg): 187.5 mg/day PO for 6 weeks >4 years (>35 kg): 250 mg/day PO for 6 weeks

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Renal Dose
Renal impairment: Use not recommended if CrCl <50 mL/min _ Contraindication Hypersensitivity, active or chronic liver disease, lactation. Mode of Action Terbinafine causes fungal cell death by inhibiting squalene epoxidase, the main enzyme in sterol biosynthesis, resulting in ergosterol deficiency within fungal cell walls. It has fungicidal activity against dermatophytes and some yeast. Precaution Preexisting liver or renal impairment, pregnancy. Perform liver function tests prior to oral therapy. Lactation: Drug excreted in breast milk; do not use _ Side Effect >10% Headache (13%) 1-10% Rash (6%),Pruritus (3%),Nausea (3%),Diarrhea (6%),Dyspepsia (4%),Abdominal pain (2%),Taste disturbance (3%),Elevated liver function test results (3%),Visual disturbance (1%) Potentially Fatal: Liver failure, Stevens-Johnson syndrome, neutropaenia.

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Interaction
Possible increase in levels in drugs metabolised by CYP450 2D6. Decreased terbinafine concentration with rifampicin; increased terbinafine concentration with cimetidine.