ciclopirox

Action and Spectrum

Actions and Spectrum: 

ciclopirox is an antifungal medication that can act as a broad-spectrum antimicrobial and anti-inflammatory agent. It is available in various formulations, including creams, gels, and solutions, and is used to treat a range of fungal infections, including ringworm, jock itch, athlete’s foot, and nail fungus. 

ciclopirox works by inhibiting the growth and replication of fungi by disrupting their cell membrane function. It is also believed to have anti-inflammatory effects by inhibiting the production of specific pro-inflammatory cytokines. This can be particularly useful in treating inflammatory skin conditions like seborrheic dermatitis. 

In addition to its antifungal and anti-inflammatory properties, ciclopirox has been shown to have some antiviral and antibacterial activity. It has been investigated for treating viral infections like HIV, herpes simplex virus, and human papillomavirus (HPV). 

Drug Interaction

Adverse Reaction

1-10%: 

Periungual erythema (5%) 

Pruritus (1-5%) 

Erythema of the proximal nail fold (1%) 

Transient burning sensation of the skin & pain 

Dry skin 

Acne 

Rash 

<1%: 

Alopecia 

Black Box Warning

Contraindication / Caution

Contraindication/Caution: 

ciclopirox should be used with caution in individuals with a known allergy or sensitivity to ciclopirox or any other ingredients in the product. It is also essential to avoid contact with the eyes, mouth, and other mucous membranes, as irritation or burning may occur. 

Individuals with liver disease or those taking medications that affect liver function should also use ciclopirox cautiously, as it may increase the risk of liver damage or toxicity. 

Additionally, there is limited information on the safety of ciclopirox during pregnancy and breastfeeding, and it should only be used if the benefits outweigh the potential risks. Discuss the use of ciclopirox with a healthcare professional if pregnant or breastfeeding is essential. 

ciclopirox may also interact with certain medications, including oral anticoagulants and medications metabolized by the liver. It is essential to inform a healthcare professional of all medications, supplements, and herbal remedies being taken before starting ciclopirox. 

Pregnancy / Lactation

Pregnancy consideration:  

Category B 

Breastfeeding warnings:  

Drug distribution in breastmilk is unknown 

Pregnancy category: 

• Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester. 
• Category B: No evidence of risk to the fetus is found in animal reproduction studies, and there are not enough studies on pregnant women. 
• Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for a human product; Pregnant women must take care of the potential risks. 
• Category D: There is adequate data with sufficient evidence of human fetal risk from various platforms. However, despite potential dangers may be used only in emergencies for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. The drug is not for pregnant women. 
• Category N: No data for the drug under this category is available. 

Pharmacology

Pharmacology: 

ciclopirox should be used with caution in individuals with a known allergy or sensitivity to ciclopirox or any other ingredients in the product. It is also essential to avoid contact with the eyes, mouth, and other mucous membranes, as irritation or burning may occur. 

Individuals with liver disease or those taking medications that affect liver function should also use ciclopirox cautiously, as it may increase the risk of liver damage or toxicity. 

Additionally, there is limited information on the safety of ciclopirox during pregnancy and breastfeeding, and it should only be used if the benefits outweigh the potential risks. Discussing the use of ciclopirox with a healthcare professional if pregnant or breastfeeding is essential. 

ciclopirox may also interact with certain medications, including oral anticoagulants and medications metabolized by the liver. It is essential to inform a healthcare professional of all medications, supplements, and herbal remedies being taken before starting ciclopirox. 

Pharmacodynamics 

ciclopirox exerts its pharmacodynamic effects by interfering with fungal cell membrane function, inhibiting fungal growth and replication. Specifically, it chelates metal ions, such as iron, which are essential for the growth of fungi. This inhibits essential enzymes involved in fungal metabolism and cell wall synthesis, ultimately leading to cell death. 

ciclopirox has also been shown to have anti-inflammatory effects, which can be particularly useful in treating inflammatory skin conditions such as seborrheic dermatitis. It has been demonstrated to inhibit the production of specific pro-inflammatory cytokines, including interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). 

In addition to its antifungal and anti-inflammatory properties, ciclopirox has been shown to have some antibacterial and antiviral activity. Ciclopirox is believed to disrupt bacterial cell membrane function and inhibit viral replication by interfering with viral gene expression and protein synthesis. 

Pharmacokinetics: 

Absorption 

The drug is rapidly but minimally absorbed 

The half-life of the drug is 1.7 hours 

Distribution 

The protein-bound is 94-98% 

Metabolism 

The drug completely conjugates with glucuronic acid; 1-2% of it is metabolized to N-desoxyciclopirox 

Elimination and Excretion  

The drug is excreted at 1.3% in urine 

Adminstartion

Administration

ciclopirox is an antifungal medication that can be used to treat a variety of fungal infections, including those of the skin, nails, and scalp.  

The administration of ciclopirox will depend on the form in which it is being used. In general, it is essential to follow the instructions provided by your healthcare provider or pharmacist. 

The affected area should be cleaned and dried before applying the medication for topical applications, such as creams or gels. The medication should be applied thinly and evenly over the affected area and gently rubbed until absorbed. 

For shampoo, the hair and scalp should be wetted thoroughly, and a small amount of shampoo should be applied and massaged into the scalp. Leave onto the scalp for a few minutes before rinsing it with water. 

Patient Information Leaflet

Patient information leaflet 

Generic Name:  ciclopirox 

Pronounced: sye-kloe-PEER-ox 

Why do we use ciclopirox? 

ciclopirox is primarily used to treat fungal infections of the skin, hair, and nails, including tinea pedis (athlete’s foot), tinea corporis (ringworm), tinea cruris (jock itch), and onychomycosis (fungal infection of the toenails or fingernails). It has broad-spectrum antifungal activity against various fungi, including dermatophytes, yeasts, and molds. 

In addition to its antifungal properties, ciclopirox has also shown some antibacterial and antiviral activity, although these effects need to be better established. This has led to the use of ciclopirox in treating certain bacterial and viral skin infections, including acne vulgaris and herpes simplex virus infections. 

ciclopirox has also been demonstrated to have anti-inflammatory effects, which can be particularly useful in treating inflammatory skin conditions such as seborrheic dermatitis.