Positives

• A patient described oral terbinafine as effective for systemic dermatophyte and onychomycosis at standard 250 mg/day dosing, with most adverse events mild and self-limited NIH Bookshelf.
  
  
• A patient noted terbinafine accumulates in keratin and skin lipids, allowing shorter courses than azoles MSK.
  
  

Negatives

• A patient reported terbinafine-induced taste loss (dysgeusia) severe enough to cause weight loss and depressive symptoms, sometimes lasting months or never resolving PubMed.
  
  
• A patient described hepatitis and elevated liver enzymes prompting drug discontinuation RxList.
  
  

Hurdles & Side Effects

• A patient noted requirement for baseline and follow-up LFTs, with insurance often requiring positive culture before authorizing systemic therapy Mayo Clinic.
  
  
• A patient cited fear of permanent taste loss as the reason they hesitated to start the drug despite physician recommendation WHO/EMRO.