Table 6.

Pulse dosing regimens evaluated for terbinafine in the treatment of onychomycosis

Author/Journal published	Recommendations	Outcomes	Conclusions
Gupta et al.[16] JEADV 2009	3 Groups: Toenail OM Group I (TOT): Terbinafine 250 mg/d for 4 weeks, followed by 4 weeks off, followed by additional 4 weeks Group II (CTERB): Terbinafine 250 mg/d for 12 weeks Group III: Itraconazole pulse of 200 mg/d twice daily for 7 days on and 21 days off. Three such pulses given	TOT, CTERB, and III groups: Mycological cure rate: 83.7%, 78.1%, 56.7% (P=0.01 for Group I vs. III) Effective cure rates: 79.1%, 65.6%, 36.7% (P <0.001 for Group I vs. III)	Intermittent terbinafine regimen provided similar efficacy and safety to the gold standard continuous terbinafine regimen and better effective cure rates than pulse itraconazole therapy.
Alpsoy et al. J dermatol 1996	Group 1: 250 mg/d of terbinafine for 3 months Group 2: 500 mg/d of terbinafine for 7 days for the first week of each month for 3 months	Cure rate 79.2% in Group 1 and 73.9% in Group 2; (P: 0.79).	Continuous and intermittent terbinafine therapy found equally effective for dermatophyte toenail onychomycosis
Warshaw et al. Arch Dermatol 2001	3 Groups (4 months each) Standard continuous terbinafine (250 mg/d) Weekly intermittent terbinafine (500 mg/d for 1 week/month) Single dose terbinafine (1000 mg/month)	Complete cure rates: 20%, 40% and 0% in respective groups Mycological cure rates: 40%, 60% and 0% in respective groups	Efficacy of continuous and weekly dosing was comparable. However, monthly doses were not effective
Yadav P et al. IJDVL 2015	Two groups Continuous terbinafine 250 mg daily for 12 weeks 3 pulses of terbinafine (each of 500 mg daily for a week) repeated every 4 weeks.	Clinical effectivity: 86.8% vs. 71.1% (P=0.280) Mycological cure rates: 28.9% vs. 18.4% (P=0.280)	Terbinafine pulse dosing as efficacious as continuous dosing