Ciclopirox

What is Ciclopirox?

Ciclopirox Topical Solution 8% is formulated with ciclopirox, a synthetic antifungal compound designed for external application to fingernails, toenails, and the surrounding skin.

Each gram of this solution contains 80 mg of ciclopirox, suspended in a base composed of a butyl ester of poly (vinylmethylether/maleic acid copolymer) dissolved in isopropyl alcohol and ethyl acetate. These solvents, ethyl acetate and isopropyl alcohol, evaporate shortly after application.

The Ciclopirox Topical Solution, 8%, appears as a transparent, colorless to slightly yellowish liquid.

What is Ciclopirox Nail Lacquer Used For?

Ciclopirox Topical Solution, 8%, is prescribed as part of a comprehensive treatment plan for individuals with mild to moderate onychomycosis of the fingernails and toenails caused by Trichophyton rubrum, provided the lunula is not affected. The treatment plan includes regular removal of detached, infected nail portions, typically on a monthly basis, by a healthcare professional with expertise in diagnosing and managing nail disorders, including minor procedures.

How This Remedy Works

Ciclopirox’s mechanism of action has been examined through multiple experimental models, including in vitro and in vivo studies. Research indicates that ciclopirox binds to trivalent metal ions such as iron (Fe³⁺) or aluminum (Al³⁺), disrupting metal-dependent enzymes critical for neutralizing peroxides in fungal cells.

In an in vitro penetration study, radioactively tagged ciclopirox was applied to infected, surgically removed toenails, which reached depths of approximately 0.4 mm, with diminishing concentrations at greater nail depths. These findings suggest limited penetration through the nail plate, though clinical implications are unclear.

Read more about clinical studies of this remedy in DailyMed.nlm.nih.gov, the library of medicine.

How Ciclopirox Nail Lacquer Works

Ciclopirox Nail Lacquer works through a unique mechanism that involves the chelation of polyvalent cations, which disrupts metal-dependent enzymes responsible for degrading peroxides within fungal cells. This action inhibits intracellular energy production and disrupts fungal nutrient uptake, reducing amino acid and nucleotide synthesis and protein production. The lacquer uses a transungual delivery system, allowing the active ingredient to penetrate the nail plate effectively. As the solvent evaporates, the concentration of the active ingredient increases, facilitating its distribution throughout the nail. This approach provides a localized treatment for mild to moderate onychomycosis without systemic side effects.

Does It Penetrate the Nail?

Yes, it penetrates the nail structure to fight the infection effectively. Its formulation allows the remedy to permeate the nail, delivering the antifungal agent directly to the site of infection. This is vital because nail fungus resides beneath the nail plate, requiring a medication that can reach the affected area.

How to Use Ciclopirox Nail Lacquer

Using the Nail Lacquer correctly is essential for effectively treating fungal infections. Proper application ensures the medication penetrates the nail and surrounding skin, targeting the fungus directly and preventing its growth. Inconsistent use or premature discontinuation can lead to incomplete treatment, allowing the infection to persist or return.

How to Apply

How Long to Use the Nail Lacquer

Treatment duration is often several months and typically lasts six months or more. Consistent application and patience are key to achieving results. The long treatment period is necessary because nails grow slowly, and it takes time for the healthy nail to replace the infected part. Consistency is crucial for successful treatment outcomes.

How to Remove

Ciclopirox Topical Solution, 8%, should not be removed daily. Generally, the lacquer should be removed once a week.

Apply a new layer each day over the previous one, and once every seven days, remove all accumulated layers using alcohol. This weekly cycle should be repeated throughout the course of treatment. After removal, file away any loose portions of the infected nails and reapply the medication. Follow your doctor’s instructions on removal.

Does Ciclopirox Work?

It is an antifungal medication that effectively treats nail fungus, but its success varies. The effectiveness depends on factors such as the severity of the infection, how well the medication penetrates the nail, and consistent application. While some individuals may experience significant improvement, others may find the results less satisfactory.

Effectiveness of Ciclopirox Nail Lacquer

The success rates of this nail lacquer in clinical trials vary, often showing a range from 30% to 40% clearance of the infection.

Regular follow-ups with a healthcare provider can help monitor progress and adjust the treatment as needed.

How Long Does It Take to Work?

Visible improvement may take several months. It typically takes at least three to six months to see noticeable changes. The slow growth rate of nails means it takes time for the healthy nail to replace the infected part.

How Do You Know if the Remedy Is Working?

The signs of visible improvement in the condition of the nail include:

• The yellow or white discoloration of the nail starts to fade.
• Тew nail growth appears clear and healthy, without signs of infection.
• The nail becomes less thick and brittle.
• The overall structure of the nail improves, with reduced crumbling or splitting.

Side Effects

While the remedy is generally well-tolerated, some side effects can occur.

Common side effects include:

• redness;
• itching;
• burning sensation;
• irritation at the application site;
• nail discoloration.

It’s essential to report any severe or persistent side effects to your healthcare provider.

Consult a healthcare provider if you have liver issues. Limited evidence exists that this lacquer significantly affects the liver.

In rare cases, the infected nail may detach as the new, healthy nail grows.

Some patients informed that this nail lacquer turns nails yellow. Indeed, yellowing of the nails is typically a symptom of the fungal infection itself, not a side effect of the medication.

This list of side effects may not be complete. Learn more about this nail lacquer’s side effects in Drugs.com.

Important Considerations & FAQs

Here are some frequently asked questions that clear up common misconceptions about the remedy.

Alternatives to Ciclopirox Nail Lacquer

Here are other treatment options for nail fungus (oral medications, other topical agents, laser therapy). Alternatives to this nail lacquer include:

• Oral Antifungal Medications – these are often more effective than topical treatments but may have more significant side effects. Common oral medications include terbinafine (Lamisil) and itraconazole (Sporanox).
• Other antifungal nail lacquers or creams may be used, but their effectiveness can vary. Examples include Efinaconazole (Jublia) and amorolfine (Loceryl).
• Laser Therapy – laser treatment can target and kill the fungus, but it may require multiple sessions and can be costly.
• Surgical removal – in severe cases, surgical removal of the infected nail may be necessary.
• Jublia (efinaconazole) is another topical treatment for onychomycosis. Studies have shown that Jublia may have a higher success rate in some cases than Ciclopirox. Still, discussing the best option with your healthcare provider is essential.

Preparations

Drug Nomenclature

International Nonproprietary Names (INNs) in main languages (French, Latin, and Spanish):

European Pharmacopoeia, 6th ed. (Ciclopirox).

A white or yellowish-white, crystalline powder. Slightly soluble in water, freely soluble in alcohol and in diehloromethane. Protect from light.

The United States Pharmacopeia 31, 2008 (Ciclopirox).

A white to slightly yellowish white, crystalline powder. Slightly soluble in water, freely soluble in dehydrated alcohol and in dichloromethane, soluble in ether. Store at a temperature of 15° to 30°. Protect from light.

Brand Names in Different Countries

Here is a table with different brand names of Ciclopirox in various countries: