Clinical Effect of Caffeine Consumption in Patients Taking Oral Terbinafine

Terbinafine is a common oral medication used for moderate to severe nail onychomycosis.On the terbinafine package insert, it states that terbinafine can reduce clearance ofcaffeine by 19%. However, the clinical effects of this finding in patients have yet toreally be studied. Decreased clearance of caffeine can physically present with measurablesigns such as an increased blood pressure or increased heart rate, as well as lessmeasurable symptoms of GI upset, irritability, headache, insomnia. As a result,dermatologists do not always know how to counsel patients taking terbinafine on theircaffeine intake. Hence, recommendations vary as no studies have been done on whethercaffeine consumption while taking terbinafine is associated with clinical outcomes, suchas measurable changes in blood pressure or heart rate.This will be a preliminary single‐blind randomized control clinical study. Patients beingstarted on oral terbinafine by video visit will be approached for enrollment in thestudy. Patients will be provided with the baseline survey, to assess demographicinformation, BMI, and daily caffeine intake. Patients with a history of hypertension andanxiety will not be enrolled per the exclusion criteria. If the patient's blood pressureor heart rate are abnormal, they will be removed from the studyWe hypothesize that there would be significant changes in blood pressure or heart rate inpatients consuming caffeine while taking terbinafine.