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Ciclopirox

LOPROX

What it isHydroxypyridone antifungal chelating polyvalent cations; onychomycosis and tinea.

Why this oneTopical, so it avoids the hepatotoxicity and interactions of oral terbinafine or itraconazole.

What limits itCure rates in onychomycosis are low and it takes up to 48 weeks of daily lacquer application.

FDA-approved for

FDA label

FDA dosingPopulationStartTargetMax
Tinea (pedis/cruris/corporis), candidiasis, tinea versicolorAdultsApply BID (morning and evening)Apply BID

Renal Undefined

Hepatic Undefined

Instructions

Cautions

Adverse reactions

Pregnancy Undefined

Lactation Undefined

NO BOXED WARNINGS

Principal riskLow cure rate after 48 weeks of application

Cost, est. cash$5–$150/month

Generic entry2004

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4
Overdose danger2 / 4
Weight-gain liability0 / 4
Sedation liability0 / 4
QT / Torsades0 / 4
Direct muscarinic antagonism0 / 4
Embryofetal risk1 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityHepatotoxicity and clinically important CYP/QT interactions; organ toxicity varies markedly by agent.

Mechanism of action: Ciclopirox ballicule

Ciclopirox ballicule: receptor binding, kinetics and half-life diagram

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