Ciclopirox

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

6-Cyclohexyl-1-hdroxy-4-methyl-2(1H)-pyridinone; CAS-Nummer:29342-05-0; Ciclopiroxum; (e) Ciclopirox

Definition
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Topical hydroxypiridone antimycotic (ciclopiroxolamine) with broad fungicidal and sporocidal activity.

Pharmacodynamics (Effect)
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Effective against dermatophytes, yeasts and moulds (DHS). An effectiveness gap as with some azole antifungals or resistances has not been described so far.

Primary fungicidal effect by inhibition of numerous key enzymes of the protein biosynthesis of fungal cells because the m-RNA synthesis is massively disturbed. In addition, the inhibition of catalase leads to H2O2 accumulation within fungal cells, which leads to secondary cell death.

Remarkable is also the antibacterial efficacy (e.g. against accompanying germs in fungal infections). In addition, good anti-inflammatory effect through competitive inhibition of key enzymes (5-lipoxygenase, cyclooxygenase) in the arachidonic acid metabolism. This secondarily inhibits the synthesis of inflammatory mediators such as leukotrienes and prostaglandins.

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Indication
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Infections by dermatophytes, yeasts and moulds.

Limited indication
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Pregnancy.

Dosage and method of use
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  • Mycoses: Apply a thin layer of cream 1-3 times/day for 3-4 weeks on the affected skin areas, if necessary powder once/day for follow-up treatment.
  • In case of candidosis or mycoses of the vagina, apply the applicator filling 1 time per day and insert the vaginal cream deep intravaginally (partner treatment!).
  • Tinea unguium: Apply varnish once/day to the affected nail, file the nail once/week, use for a maximum of 6 months.

Standard concentration
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1% as solution, cream or powder, 1% as vaginal cream, 8% as nail polish (Sonthalia S et al. 2019).

Undesirable effects
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Allergic reactions, skin irritation, skin dryness due to solution, pruritus.

Contraindication
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Hypersensitivity to the active substance, children < 2 years.

Preparations
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Batrafen, Nail Batrafen, Ciclopoli, Stieprox intensive, Ciclopirox Winthrop nail polish, Batrafen vaginal cream

Literature
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  1. Lipner SR et al (2019) Onychomycosis: Treatment and prevention of recurrence. J Am Acad Dermatol 80:853-867.
  2. Sonthalia S et al (2019) Topical Ciclopirox Olamine 1%: Revisiting a Unique Antifungal. Indian Dermatol Online J 10: 481-485.

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Last updated on: 29.10.2020