Ciclopirox
From Pharmacopedia
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Ciclopirox
Penlac (nail lacquer), Loprox (cream/lotion/shampoo)
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Summary
Classes
Common uses
Tinea pedis / cruris / corporis0, Cutaneous candidiasis0, Seborrheic dermatitis (shampoo)0, Onychomycosis (mild distal subungual; nail lacquer)0
Pharmacy
Starting dose
Topical cream/lotion BID; shampoo twice weekly; nail lacquer (Penlac) once daily for up to 48 weeks
Preparations
0.77% topical cream, lotion, suspension; 1% shampoo; 8% nail lacquer (Penlac)
US FDA Max
BID topical; once daily nail lacquer
Pharmacology
Routes
Topical
Onset
Days for dermatophyte clearance; nail clearance over months
Duration
Hours per application
Half-life
Not meaningfully described (topical local action)[1]
Bioavailability
Topical with minimal systemic absorption[1]
Pregnancy
Generally considered safe (minimal systemic absorption).[citation needed]
Legal status
Rx-only in US
Purported mechanism
Ciclopirox is a hydroxypyridone antifungal with a mechanism distinct from azoles and allylamines; it chelates polyvalent cations (Fe³⁺, Al³⁺), disrupting cofactor-dependent fungal enzymes (cytochromes, catalases, peroxidases) and producing fungicidal activity against dermatophytes, Candida, and Malassezia.0 Onychomycosis cure rates with nail lacquer are modest (mycologic cure ~30-50%, complete cure ~5-12% at 48 weeks); oral terbinafine remains substantially more effective when systemic therapy is acceptable[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Penlac (ciclopirox) topical solution, Sanofi-Aventis, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021022s015lbl.pdf