Treating onychomycosis in hepatitis patients

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Can Lamisil (terbinafine) be used in onychomycosis patients who have hepatitis B or C with normal or minimally elevated liver function tests (LFTs)?
—Wally Litwa, DO, Clinton Park, N.Y.

Such treatment is possible, but exercise caution. Discuss the risks with the patient and monitor LFTs every month, rather than every six weeks. Carefully instruct the patient to be vigilant for signs and symptoms of hepatic dysfunction. At the first sign of a problem, discontinue treatment immediately.
—Jeffrey Weinberg, MD (110-6)

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