Oral Antifungal Treatment

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I've been prescribed an oral antifungal of the allylamines class, generic 'terbinafine' (aka Lamisil), 250mg/day for 90 days. It inhibits the production of ergosterol, a key molecule in fungal cell walls. My goal is to treat a systemic fungal infection on my toenails and skin. I don't expect this to be a cure for the underlying cause, whatever that may be, but I'd like to reduce the damage to my skin and nails for the time being, not to mention the incessant itching!

 

I've learned enough at this point to not take prescriptions at face value. I specifically requested an allylamine, basically by saying I wanted anything that was not an azole. I know the risks of this drug include elevated liver enzymes (but hopefully not CYP450s). I suspect the risks also include a change to my gut microbiome, as well as the general "who knows?" that comes with trialing a toxic drug.

 

I am trying to minimize these risks, both known and unknown, by doing two things:

1) Titrating up slowly from 1/4 tablet to 1 full tablet per day over a week or two, while watching for symptoms.

2) Pulsing 2 weeks on at 250mg/day and 2-3 weeks off, as described in the following Wikipedia exerpt.

 

This accumulation results in therapeutic levels of terbinafine even after 80 days following one week treatment of 250 mg/day. Different dosing schedules have been proposed such as 500 mg/day for one week or 250 mg/day for two weeks each followed by a drug-free period of three or two weeks, totaling 3 months of treatment including the drug-free periods. Such intermittent dosing schedules appear to be as effective as continuous regimes.

https://en.wikipedia.org/wiki/Terbinafine

 

Any suggestions from other taperers who have used oral antifungals while tapering?

Thanks! 

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How has it been your experience with Terbinafine? Any bad reaction to it?