Ciclopirox
Other antifungals
Other antifungals
Broad-spectrum topical antifungal (a hydroxypyridone) for tinea, skin candidiasis, pityriasis versicolor and, as a nail lacquer, onychomycosis.
Also called: ciclopirox olamine
Quick facts
- Group
- Other antifungals
- Target
- Metal-dependent fungal enzymes (through cation chelation)
- Used for
- Tinea pedis · Cutaneous candidiasis · Pityriasis
- Key effects
- Redness · With the lacquer
- Monitor
- Nail response
- ATC
- D01AE14
No doses: the clinician sets them by the current guideline.
Mechanism of action
Ciclopirox is a hydroxypyridone that chelates polyvalent cations, above all trivalent ones such as iron. Without those metals the enzymes that break down peroxides inside the fungus fail, the peroxides build up and damage it. It is fungicidal against Candida albicans and dermatophytes such as Trichophyton rubrum, and also inhibits Malassezia.
- Penetrates the epidermis and reaches the dermis
- Chelates metal cations inside the fungus
- Peroxide-degrading enzymes fail
- The fungus is damaged and dies
Indications
- Tinea pedis, cruris and corporis Dermatophytosis (tinea) and onychomycosis →
- Cutaneous candidiasis by Candida albicans Cutaneous and mucocutaneous candidiasis →
- Pityriasis (tinea) versicolor
- Mild to moderate onychomycosis of fingers and toes (nail lacquer), with regular nail trimming
- Seborrhoeic dermatitis of the scalp (gel and shampoo) Seborrheic dermatitis →
Adverse effects
Common
- Redness, burning or itching at the application site
- With the lacquer: irritation of the skin around the nail, nail colour or shape change and ingrown nail
Contraindications
- Hypersensitivity to ciclopirox or any component of the product
Key interactions
- Nail polish and nail cosmetics
- Avoided on nails treated with the lacquer.
What is monitored
- Irritation or sensitisation at the application site
- Nail response: improvement takes months and complete cure is uncommon
Administration and safety
- External use only: not applied to eyes, nose, mouth or vagina
- The lacquer is applied over the previous layer and removed once a week with alcohol, along with trimming the damaged nail
- The lacquer is flammable: kept away from heat, flames and cigarettes
Pregnancy and breastfeeding
It was not teratogenic in animals and absorption is minimal; adequate studies in pregnant women are lacking, so it is used when the benefit justifies it.
Nursing care
- Teach nail care: clean, dry, trimmed nails and no shared nail clippers
- Explain that onychomycosis improves over months and treatment is not stopped without advice
- Ask about diabetes or peripheral vascular disease before treating nails
- Ask the patient to report blisters, oozing or nail pain
Pharmacokinetics
- Absorption
- Topical; systemic absorption is minimal (about 1% of the applied dose).
- Distribution
- Penetrates the skin, hair follicles and sebaceous glands.
Test yourself
Think of the answer, then tap the question to see it.
How does ciclopirox work?
It chelates trivalent metal cations and inhibits metal-dependent fungal enzymes, such as those that break down peroxides.
How effective is ciclopirox nail lacquer for onychomycosis?
It is well tolerated, but complete cure is uncommon and improvement takes months; it is combined with nail trimming.
What practical precaution applies to ciclopirox nail lacquer?
It is flammable: it is kept away from heat, flames and cigarettes.
Connections
← Back to the class: Other antifungals
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - CICLOPIROX OLAMINE cream (DailyMed (U.S. National Library of Medicine), 2026); Ciclopirox Topical: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026).
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Representative model, for educational purposes only.