Skip to main content

Ciclopirox

Recent Nonclinical and Clinical Data Relevant to its Use as a Topical Antimycotic Agent

Drugs volume 70, pages 2133–2152 (2010)Cite this article

Abstract

Ciclopirox is a topical antimycotic agent belonging to the chemical class of hydroxypyridones and not related to azoles or any other class of antifungal agents. Its antimicrobial profile includes nearly all of the clinically relevant dermatophytes, yeasts and moulds, and is therefore broader than that of most other antimycotics. It is also active against certain frequently azole-resistant Candida species and against some bacteria.

The mechanism of action of ciclopirox is different from that of other topical antifungal drugs, which generally act through ergosterol inhibition. The high affinity of ciclopirox for trivalent metal cations, resulting in inhibition of the metal-dependent enzymes that are responsible for the degradation of peroxides within the fungal cell, appears to be the major determinant of its antimicrobial activity. This unique and multilevel mechanism of action provides a very low potential for the development of resistance in pathogenic fungi, with cases of resistance rarely reported.

Ciclopirox also displays mild anti-inflammatory effects in biochemical and pharmacological models; effects also shown in small clinical studies. Scavenging of reactive oxygen species released from inflammatory cells is a likely contributor to these anti-inflammatory effects.

Ciclopirox, and its olamine salt, is available in multiple topical formulations, suitable for administration onto the skin and nails and into the vagina. The pharmaceutical forms most widely investigated are 1% ciclopirox olamine cream and 8% ciclopirox acid nail lacquer, but lotion, spray, shampoo, pessary, solution, gel and douche formulations have also been used. Ciclopirox penetrates into the deep layers of the skin, mucosal membranes and nail keratin, reaching concentrations exceeding the minimal fungicidal concentrations for most medically important fungi.

A large number of clinical trials were and are still being performed with ciclopirox, starting in the early 1980s. Ciclopirox was first developed for fungal skin infections and vaginal candidiasis, and is currently well established in these indications. More recently, the drug has been clinically investigated in seborrhoeic dermatitis and onychomycosis, showing good efficacy and excellent tolerability. Emphasis in this review is given to a ciclopirox medicated nail lacquer, which is based on an original technology and has superior properties in terms of its affinity to keratin and nail permeation. It has been found to have superior efficacy and safety to another commercially available formulation in the treatment of onychomycosis.

The safety features of ciclopirox are well known. The topical drug is devoid of systemic adverse reactions. Mild local reactions characterized by a burning sensation of the skin, irritation, redness, pain or pruritus, generally in less than 5% of treated patients, can be observed following skin and vaginal application. With nail application, the most common adverse event is the appearance of mild erythema in 5% of the treated population.

As a general conclusion, although less effective than some oral antimycotic agents in various indications, ciclopirox compares very well in terms of the benefit/risk ratio due to its excellent tolerability and complete absence of serious adverse effects.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 49.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Table I.
Table II.
Fig. 2
Fig. 3
Table III
Table IV
Table V
Table VI
Fig. 4

References

  1. Finch JJ, Warshaw EM. Toenail onychomycosis: current and future treatment options. Dermatol Ther 2007; 20: 31–46

    Article  PubMed  Google Scholar 

  2. Topliss D, Gold M, Kotsirilos V, et al. Hepatic reactions with terbinafine. Australian Adverse Drug Reactions Bull 2008; 27(1): 3

    Google Scholar 

  3. Bennett JE. Antifungal agents. In: Hardman JG, Limbird LE, editors. Goodman & Gilman's the pharmacological basis of therapeutics. New York: McGraw-Hill, 2001: 1295–312

    Google Scholar 

  4. Chen SCA, Sorrell TC. Antifungal agents. Med J Aust 2007 Oct; 187: 404–9

    PubMed  Google Scholar 

  5. Dubini F, Bellotti MG, Frangi A, et al. In vitro antimycotic activity and nail permeation models of a piroctone olamine (octopirox) containing transungual water soluble technology. Arzneimittelforschung 2005; 55(8): 478–83

    PubMed  CAS  Google Scholar 

  6. Veraldi S, Menter A, Innocenti M. Treatment of mild to moderate seborrhoeic dermatitis with MAS064D (Sebclair), a novel topical medical device: results of a pilot, randomized, double-blind, controlled trial. J Eur Acad Dermatol Venereol 2008; 22: 290–6

    Article  PubMed  CAS  Google Scholar 

  7. Dittmar W, Lohaus G. HOE 296, a new antimycotic compound with a broad antimicrobial spectrum. Arzneimittelforschung 1973; 23: 670–4

    PubMed  CAS  Google Scholar 

  8. Jue SG, Dawson GW, Brogden RN. Cyclopirox olamine 1 % cream: a preliminary review of its antimicrobial activity and therapeutic use. Drugs 1985; 29: 330–41

    Article  PubMed  CAS  Google Scholar 

  9. Kokjohn K, Bradley M, Griffiths B, et al. Evaluation of in vitro activity of ciclopirox olamine, butenafine HCl and econazole nitrate against dermatophytes, yeasts and bacteria. Int J Dermatol 2003; 42 Suppl. 1: 11–7

    Article  PubMed  CAS  Google Scholar 

  10. Gupta AK, Kohli Y. In vitro susceptibility testing of ciclopirox, terbinafine, ketoconazole and itraconazole against dermatophytes and nondermatophytes, and in vitro evaluation of combination antifungal activity. Br J Dermatol 2003; 149: 296–305

    Article  PubMed  CAS  Google Scholar 

  11. Singh J, Zaman M, Gupta AK. Evaluation of microdilution and disk diffusion methods for antifungal susceptibility testing of dermatophytes. Med Mycol 2007; 45(7): 595–602

    Article  PubMed  CAS  Google Scholar 

  12. Shehata AS, Mukherjee PK, Ghannoum MA. Comparison between the standardized clinical and laboratory standards institute M38-A2 method and a 2,3-bis(2-methoxy-4-nitro-5-[(sulphenylamino)carbonyl]-2H-tetrazolium hydroxide-based method for testing antifungal susceptibility of dermatophytes. J Clin Microbiol 2008 Nov; 46(11): 3668–71

    Article  PubMed  CAS  Google Scholar 

  13. Czaika V, Tietz HJ, Schmalreck A. Antifungal susceptibility testing in chronically recurrent vaginal candidosis as basis for effective therapy. Mycoses 2000; 43 Suppl. 2: 45–50

    Article  PubMed  CAS  Google Scholar 

  14. Figueiredo VT, de Assis Santos D, Resende MA, et al. Identification and in vitro antifungal susceptibility testing of 200 clinical isolates of Candida spp. responsible for fingernail infections. Mycopathologia 2007; 164(1): 27–33

    Article  PubMed  CAS  Google Scholar 

  15. Tosti A, Piraccini BM, Lorenzi S. Onychomycosis caused by nondermatophytic molds: clinical features and response to treatment of 59 cases. J Am Acad Dermatol 2000 Feb; 42(2): 217–24

    Article  PubMed  CAS  Google Scholar 

  16. Bonifaz A, Cruz-Aguilar P, Ponce RM. Onychomycosis by molds: report of 78 cases. Eur J Dermatol 2007 Jan–Feb; 17(1): 70–2

    PubMed  Google Scholar 

  17. Bontems O, Hauser PM, Monod M. Evaluation of a polymerase chain reaction-restriction fragment length polymorphism assay for dermatophyte and nondermatophyte identification in onychomycosis. Br J Dermatol 2009 May; 161(4): 791–6

    Article  PubMed  CAS  Google Scholar 

  18. Goudard M, Regli P, Lubrano N. In vitro antifungal spectrum of ciclopiroxolamine. Pathol Biol (Paris) 1989 Jun; 37: 621–3

    CAS  Google Scholar 

  19. Macura AB, Pawlik B, Szczepko I. The susceptibility of Aspergillus and Penicillium to recent antimycotics. Wiad Parazytol 2000; 46(1): 157–62

    PubMed  CAS  Google Scholar 

  20. Singh J, Rimek D, Kappe R. In vitro susceptibility of 15 strains of zygomycetes to nine antifungal agents as determined by the NCCLS M38-A microdilution method. Mycoses 2005; 48(4): 246–50

    Article  PubMed  CAS  Google Scholar 

  21. Gemmer CM, DeAngelis YM, Theelen B, et al. Fast, non-invasive method for molecular detection and differentiation of Malassezia yeast species on human skin and application of the method to dandruff microbiology. J Clin Microbiol 2002 Sep; 40(9): 3350–7

    Article  PubMed  CAS  Google Scholar 

  22. Crespo-Erchiga V, Gómez-Moyano E, Crespo M. Pityriasis versicolor and the yeasts of genus Malassezia. Actas Dermosifiliogr 2008 Dec; 99(10): 764–71

    Article  PubMed  CAS  Google Scholar 

  23. Roques C, Brousse S, Panizzutti C. In vitro antifungal efficacy of ciclopirox olamine alone and associated with zinc pyrithione compared to ketoconazole against Malassezia globosa and Malassezia restricta reference strains. Mycopathologia 2006; 162(6): 395–400

    Article  PubMed  CAS  Google Scholar 

  24. Gupta AK, Plott T. Ciclopirox: a broad-spectrum antifungal with antibacterial and anti-inflammatory properties. Int J Dermatol 2004; 43 Suppl. 1: 3–8

    Article  PubMed  CAS  Google Scholar 

  25. Carrillo-Muñoz AJ, Giuliano G, Ezkurra PA, et al. Antifungal agents: mode of action in yeast cells. Rev Esp Quimioterap 2006; 19: 130–9

    Google Scholar 

  26. Abrams BB, Hänel H, Hoehler T. Ciclopirox olamine: a hydroxypyridone antifungal agent. Clin Dermatol 1991; 9:471–7

    Article  PubMed  CAS  Google Scholar 

  27. Niewerth M, Kunze D, Seibold M, et al. Ciclopirox olamine treatment affects the expression pattern of Candida albicans genes encoding virulence factors, iron metabolism proteins, and drug resistance factors. Antimicrob Agents Chemother 2003; 47: 1805–17

    Article  PubMed  CAS  Google Scholar 

  28. Sigle HC, Thewes S, Niewerth M, et al. Oxygen accessibility and iron levels are critical factors for the antifungal action of ciclopirox against Candida albicans. J Antimicrob Chemother 2005; 55: 663–73

    Article  PubMed  CAS  Google Scholar 

  29. Sigle HC, Schäfer-Korting M, Korting HC, et al. In vitro investigations on the mode of action of the hydroxypyridone antimycotics rilopirox and piroctone on Candida albicans. Mycoses 2006; 49(3): 159–68

    Article  PubMed  CAS  Google Scholar 

  30. Lee RE, Liu TT, Barker KS. Genome-wide expression profiling of the response to ciclopirox olamine in Candida albicans. J Antimicrob Chemother 2005; 55: 655–62

    Article  PubMed  CAS  Google Scholar 

  31. Braga PC, Piatti G, Conti E, et al. Effects of subinhibitory concentrations of ciclopirox on the adherence of Candida albicans to human buccal and vaginal epithelial cells. Arzneimittelforschung 1992; 42: 1368–71

    PubMed  CAS  Google Scholar 

  32. De Bernardis F, Sullivan PA, Cassone A. Aspartyl proteinases of Candida albicans and their role in pathogenicity. Med Mycol 2001; 39: 303–13

    Article  PubMed  Google Scholar 

  33. Schaller M, Krnjaic N, Niewerth M, et al. Effect of antimycotic agents on the activity of aspartyl proteinases secreted by Candida albicans. J Med Microbiol 2003; 52: 247–9

    Article  PubMed  CAS  Google Scholar 

  34. Sakurai K, Sagakuchi T, Yamaguchi H, et al. Mode of action of 6-cyclohexyl-l-hydroxy-4-methyl-2(1H) pyridone ethanolamine salt (Hoe 296). Chemotherapy 1978; 24: 68–76

    Article  PubMed  CAS  Google Scholar 

  35. Carrillo-Muñoz AJ, Brió S, Alonso R, et al. Ciclopiroxolamine: in vitro antifungal activity against clinical yeast isolates. Int J Antimicrob Agents 2002; 20(5): 375–9

    Article  PubMed  CAS  Google Scholar 

  36. Tietz HJ. Therapy problems in chronic recurrent vaginal mycosis. Ther Umsch 2002; 59(9): 481–4

    Article  PubMed  CAS  Google Scholar 

  37. Hänel H, Smith-Kurtz E, Pastowsky S. Therapy of seborrheic eczema with an antifungal agent with an antiphlogistic effect. Mycoses 1991; 34 Suppl. 1:91–3

    PubMed  Google Scholar 

  38. Rosen T, Schell B, Orengo I. Anti-inflammatory activity of antifungal preparations. Int J Derm 1997; 36: 788–92

    Article  PubMed  CAS  Google Scholar 

  39. Lassus A, Nolting KS, Savopoulos C. Comparison of ciclopirox 1% hydrocortisone acetate 1% cream in the treatment of inflamed superficial mycoses. Clin Ther 1988; 10: 594–9

    PubMed  CAS  Google Scholar 

  40. Nakashima T, Sato E, Niwano Y, et al. Inhibitory or scavenging action of ketoconazole and ciclopiroxolamine against reactive oxygen species released by primed inflammatory cells. Br J Dermatol 2007; 156(4): 720–7

    Article  PubMed  CAS  Google Scholar 

  41. Sato E, Kohno M, Nakashima T, et al. Ciclopirox olamine directly scavenges hydroxyl radical. Int J Dermatol 2008; 47(1): 15–8

    Article  PubMed  CAS  Google Scholar 

  42. Zaneveld LJ, Waller DP, Sellors J, et al. Ciclopiroxolamine: a vaginal product with microbicide potential [online]. Available from URL: www.path.org/files/TS_ ciclo_microb_poster.pdf [Accessed 2009 Jul 25]

  43. Hoque M, Hanauske-Abel HM, Palumbo P, et al. Inhibition of HIV-1 gene expression by ciclopirox and deferiprone, drugs that prevent hypusination of eukaryotic initiation factor 5A. Retrovirology 2009 Oct 13; 6: 90

    Article  PubMed  CAS  Google Scholar 

  44. Clement PM, Hanauske-Abel HM, Wolff EC. The antifungal drug ciclopirox inhibits deoxyhypusine and proline hydroxylation, endothelial cell growth and angiogenesis in vitro. Int J Cancer 2002; 100(4): 491–8

    Article  PubMed  CAS  Google Scholar 

  45. Park JH, Aravind L, Wolff EC, et al. Molecular cloning, expression, and structural prediction of deoxyhypusine hydroxylase: a HEAT-repeat-containing metalloenzyme. Proc Natl Acad Sci U S A 2006; 103(1): 51–6

    Article  PubMed  CAS  Google Scholar 

  46. Cracchiolo B. Chemoprevention of cancer in the lower female genital tract: the antineoplastic activity of the fungicide ciclopirox [ClinicalTrials.gov identifier NCT00382330]. US National Institutes of Health, ClinicalTrials.gov [online]. Available from URL: http://clinicaltrials.gov [Accessed 2009 Jul 25]

  47. Eberhard Y, McDermott SP, Wang X, et al. Chelation of intracellular iron with the antifungal agent ciclopirox olamine induces cell death in leukemia and myeloma cells. Blood 2009; 114(14): 3064–73

    Article  PubMed  CAS  Google Scholar 

  48. Zhou H, Shen T, Luo Y, et al. The antitumor activity of the fungicide ciclopirox. Int J Cancer. Epub 2010 Mar 11

  49. Saeftel M, Sarite RS, Njuguna T, et al. Piperidones with activity against Plasmodium falciparum. Parasitol Res 2006; 99(3): 281–6

    Article  PubMed  Google Scholar 

  50. Kellner HM, Amold C, Christ OE. Untersuchungen zur Pharmakokinetik und Biotrasformation des Anti-mykotikums Cicclopiroxolamin bei Tieren und bei Menschen nach topischer und systemischer Anwendung. Arzneimittelforschung 1981; 31: 1337–53

    PubMed  CAS  Google Scholar 

  51. Bonelli M, Cattabeni F, Ragusa MC, et al. Escrezione urinaria della ciclopirox olamina dopo applicazione topica sulla cute umana. Ann It Derm Clin Sper 1983; 37: 397–401

    Google Scholar 

  52. Ceschin-Roques CG, Hänel H, Pruja-Bougaret SM, et al. Ciclopiroxolamine cream 1%: in vitro and in vivo penetration into the stratum corneum. Skin Pharmacol 1991; 4(2): 95–9

    Article  PubMed  CAS  Google Scholar 

  53. Coppi G, Silingardi S, Girardello R. Pharmacokinetics of ciclopirox olamine after vaginal application to rabbits and patients. J Chemother 1993; 5: 302–6

    PubMed  CAS  Google Scholar 

  54. Messina P, Girardello R, Giannella C, et al. Systemic bioavailability study of ciclopirox olamine vaginal ovules (Dafnegin®) administered in repeated dose regimen to 6 females suffering from vaginal infections due to Candida. Lugano: Polichem SA, 1997. (Data on file)

    Google Scholar 

  55. Bohn M, Kraemer KT. Dermatopharmacology of ciclopirox nail lacquer topical solution 8% in the treatment of onychomycosis. J Am Acad Dermatol 2000 Oct; 43(4): S57–69

    Article  PubMed  CAS  Google Scholar 

  56. Monti D, Saccomani L, Chetoni P, et al. In vitro transungual permeation of ciclopirox from a hydroxypropyl chitosan-based, water-soluble nail lacquer. Drug Dev Ind Pharm 2005 Jan; 31(1): 11–7

    PubMed  CAS  Google Scholar 

  57. Monti D, Saccomani L, Chetoni P, et al. Hydrosoluble medicated nail lacquers: in vitro drug permeation and corresponding antimycotic activity. Br J Dermatol 2009; 162: 311–7

    Article  PubMed  Google Scholar 

  58. Monti D, Saccomani L, Chetoni P, et al. Development of a drug permeation model through human infected nails and relationship with bovine hoof slices. J Invest Dermatol 2007; 127 Suppl. 2: S64

    Google Scholar 

  59. Mailland F, Baran R, Caserini M. Pharmacokinetic/ pharmacodynamic relationship of a new nail lacquer in the treatment of onychomycosis [poster]. 6th European Academy of Dermatology and Venereology (EADV) Spring Symposium: Skin and quality of life; 2009 Apr 23–26; Bucharest

  60. Gupta AK, Skinner AR. Ciclopirox for the treatment of superficial fungal infections: a review. Int J Dermatol 2003; 42 Suppl. 1:3–9

    Article  PubMed  CAS  Google Scholar 

  61. del Palacio A, Cuétara MS, López-Suso MJ, et al. Randomized prospective comparative study: short-term treatment with ciclopiroxolamine (cream and solution) versus boric acid in the treatment of otomycosis. Mycoses 2002 Oct; 45(8): 317–28

    Article  PubMed  Google Scholar 

  62. Szeimies RM, Wimmershoff MB, Reisberger EM, et al. Treatment of therapy refractory verrucae vulgares with a ciclopirox-containing lacquer [in German]. Hautarzt 2001 Jun; 52(6): 489–91

    Article  PubMed  CAS  Google Scholar 

  63. Adam W, Peil HG, Savopoulos C, et al. Clinical results with the antimycotic agent ciclopiroxolamine [in German]. Arzneimittelforschung 1981; 31(8A): 1360–5

    PubMed  CAS  Google Scholar 

  64. Torres J, Savopoulos C, Dittmar W. Open clinical trial in dermal mycoses of a 1% ciclopiroxolamine solution in polyethylene glycol 400 carried out in FR Germany/study with shortened therapy [in German]. Arzneimittelforschung 1981; 3: 1373–6

    Google Scholar 

  65. Fredriksson T, Savopoulos C. Comparative double-blind study on ciclopiroxolamine cream and placebo cream in dermatophytosis [in German]. Arzneimittelforschung 1981; 31(8A): 1376–8

    PubMed  CAS  Google Scholar 

  66. Beyer M. Selected double-blind comparative studies on the efficacy and tolerance of ciclopiroxolamine solution and cream [in German]. Arzneimittelforschung 1981; 31(8A): 1378–81

    PubMed  CAS  Google Scholar 

  67. Dittmar W. Non-European open clinical studies on the efficacy and tolerance of ciclopiroxolamine in dermatomycoses [in German]. Arzneimittelforschung 1981; 31(8A): 1381–5

    PubMed  CAS  Google Scholar 

  68. Bagatell FK, Bogaert H, Cullen SI, et al. Evaluation of a new antifungal cream, ciclopirox olamine 1% in the treatment of cutaneous candidosis. Clin Ther 1985; 8:41–8

    Google Scholar 

  69. Kligman AM, Bogaert H, Cordero C, et al. Evaluation of ciclopirox olamine cream for the treatment of tinea pedis: multicenter, double-blind, comparative studies. Clin Ther 1985; 7: 409–17

    Google Scholar 

  70. Cullen SI, Jacobson C, Kanof NB, et al. Treatment of tinea versicolor with a new antifungal agent, ciclopirox olamine cream 1%. Clin Ther 1985; 7: 574–83

    Google Scholar 

  71. Bogaert H, Cordero C, Ollague W, et al. Multicentre double-blind clinical trials of ciclopirox olamine cream 1 % in the treatment of tinea corporis and tinea cruris. J Int Med Res 1986; 14: 210–6

    PubMed  CAS  Google Scholar 

  72. Corte M, Jung K, Linker U, et al. Topical application of a 0.1% ciclopiroxolamine solution for the treatment of pityriasis versicolor. Mycoses 1989; 32(4): 200–3

    Article  PubMed  CAS  Google Scholar 

  73. Aly R, Maibach HI, Bagatell FK, et al. Ciclopirox olamine lotion 1 %: bioequivalence to ciclopirox olamine cream 1 % and clinical efficacy in tinea pedis. Clin Ther 1989; 11: 290–303

    PubMed  CAS  Google Scholar 

  74. Altmeyer P, Nolting S, Kuhlwein A, et al. Effect of fenticonazole spray in cutaneous mycosis: a double-blind clinical trial versus cyclopyrox olamine spray. J Int Med Res 1990; 18(1): 61–7

    PubMed  CAS  Google Scholar 

  75. Wu YC, Chuan MT, Lü YC. Efficacy of ciclopiroxolamine 1% cream in onychomycosis and tinea pedis. Mycoses 1991; 4: 93–5

    Google Scholar 

  76. Aly R, Fisher G, Katz I, et al. Ciclopirox gel in the treatment of patients with interdigital tinea pedis. Int J Dermatol 2003 Sep; 42 Suppl. 1: 29–35

    Article  PubMed  CAS  Google Scholar 

  77. Gupta AK, Skinner AR, Cooper EA. Evaluation of the efficacy of ciclopirox 0.77% gel in the treatment of tinea pedis interdigitalis (dermatophytosis complex) in a randomized, double-blind, placebo-controlled trial. Int J Dermatol 2005; 44(7): 590–3

    Article  PubMed  CAS  Google Scholar 

  78. Wajnberg M, Wajnberg A. Doppelblind-Vergleichsstudie mit Ciclopiroxolamin-und Miconazol-Vaginal creme bei vulvovaginaler Candidose [A comparative double blind trial with vaginal creams of cyclopyroxolamine and miconazole in vulvovaginal candidosis (author's transl); in German]. Mykosen 1981; 24(12): 721–30

    Article  PubMed  CAS  Google Scholar 

  79. García Figueroa RG, Sauceda L, Ramírez Palacios D, et al. Effectiveness and safety of ciclopirox olamine 1% vaginal cream versus terconazole 0.8% vaginal cream in the treatment of genital candidiasis. Ginecol Obstet Mex 2000; 68: 154–9

    PubMed  Google Scholar 

  80. Queiroz JL, Cymbalista NB. Estudio clinico com ciclopirox créme vaginal na candidiase vulvovaginal. Rev Bras Clin Ter 1980; 37: 479–84

    Google Scholar 

  81. Peil HG. Offene Studio zur Wirksamkeit und Vertrflglichkeit von Ciclopiroxolamin bei vulvovaginaler Candidose [Open clinical study on the efficacy and tolerance of ciclopiroxolamine in vulvovaginal candidosis (author's transl); in German]. Arzneimittelforschung 1981; 31(8A): 1366–8

    PubMed  CAS  Google Scholar 

  82. Damianov L, Novachkov V, Ivanov S. The treatment of acute mycotic colpitis with ciclopiroxolamine in patients using oral contraceptives [in Bulgarian]. Akush Ginekol (Sofiia) 1997; 36(1): 32–3

    CAS  Google Scholar 

  83. Novachkov V, Damianov L, Tsankova M, et al. The treatment of acute mycotic colpitis with ciclopirox olamine in pregnant patients in the 10th lunar month [in Bulgarian]. Akush Ginekol (Sofiia) 1999; 38(4): 54–5

    CAS  Google Scholar 

  84. Giannoni M, Pollastro M, Jacobellis M. A clinical study of cyclopyroxolamine versus clotrimazole in the treatment of mycotic vulvovaginitis [in Italian]. Minerva Med 1990; 81: 555–9

    PubMed  CAS  Google Scholar 

  85. Nencioni T, Pamparana F, Jacobellis M. Mycotic vulvovaginitis and topical cyclopiroxolamine [in Italian]. Minerva Ginecol 1988; 40: 719–22

    PubMed  CAS  Google Scholar 

  86. Bucciero A, Molteni E, Molteni B, et al. Ciclopiroxolamine in the topical treatment of vaginal mycoses [in Italian]. Minerva Ginecol 1989; 41: 283–6

    PubMed  CAS  Google Scholar 

  87. Shuttleworth D, Squire RA, Boorman GC, et al. Comparative clinical efficacy of shampoos containing ciclopirox olamine (1.5%) or ketonazole (2%) for the control of dandruff/seborrheic dermatitis. J Dermatol Treat 1998; 9: 157–62

    Article  CAS  Google Scholar 

  88. Vardy DA, Zvulunov A, Tchetov T, et al. A double-blind, placebo-controlled trial of a ciclopirox olamine 1% shampoo for the treatment of scalp seborrheic dermatitis. J Dermatol Treat 2000; 11: 73–7

    Article  CAS  Google Scholar 

  89. Dupuy P, Maurette C, Amoric JC, et al., on behalf of the Study Investigator Group. Randomized, placebo-controlled, double-blind study on clinical efficacy of ciclopiroxolamine 1% cream in facial seborrhoeic dermatitis. Br J Dermatol 2001; 144(5): 1033–7

    Article  PubMed  CAS  Google Scholar 

  90. Squire RA, Goode K. A randomised, single-blind, single-centre clinical trial to evaluate comparative clinical efficacy of shampoos containing ciclopirox olamine (1.5%) and salicylic acid (3%), or ketoconazole (2%, Nizoral) for the treatment of dandruff/seborrhoeic dermatitis. J Dermatolog Treat 2002; 13(2): 51–60

    Article  PubMed  CAS  Google Scholar 

  91. Unholzer A, Varigos G, Nicholls D, et al. Ciclopiroxolamine cream for treating seborrheic dermatitis: a double-blind parallel group comparison. Infection 2002; 30(6): 373–6

    Article  PubMed  CAS  Google Scholar 

  92. Aly R, Katz HI, Kempers SE, et al. Ciclopirox gel for seborrheic dermatitis of the scalp. Int J Dermatol 2003; 42 Suppl. 1: 19–22

    Article  PubMed  CAS  Google Scholar 

  93. Lebwohl M, Plott T. Safety and efficacy of ciclopirox 1% shampoo for the treatment of seborrheic dermatitis of the scalp in the US population: results of a double-blind, vehicle-controlled trial. Int J Dermatol 2004; 43 Suppl. 1: 17–20

    Article  PubMed  CAS  Google Scholar 

  94. Altmeyer P, Hoffmann K, on behalf of the Loprox Shampoo Dosing Concentration Study Group. Efficacy of different concentrations of ciclopirox shampoo for the treatment of seborrheic dermatitis of the scalp: results of a randomized, double-blind, vehicle-controlled trial. Int J Dermatol 2004; 43 Suppl. 1:9–12

    Article  PubMed  CAS  Google Scholar 

  95. Abeck D, on behalf of the Loprox Shampoo Dosing Study Group. Rationale of frequency of use of ciclopirox 1 % shampoo in the treatment of seborrheic dermatitis: results of a double-blind, placebo-controlled study comparing the efficacy of once, twice, and three times weekly usage. Int J Dermatol 2004; 43 Suppl. 1: 13–6

    Article  PubMed  CAS  Google Scholar 

  96. Shuster S, Meynadier J, Kerl H, et al. Treatment and prophylaxis of seborrheic dermatitis of the scalp with anti-pityrosporal 1% ciclopirox shampoo. Arch Dermatol 2005; 141(1): 47–52

    Article  PubMed  CAS  Google Scholar 

  97. Mayser P, Kupfer J, Nemetz D, et al. Treatment of head and neck dermatitis with ciclopiroxolamine cream: results of a double-blind, placebo-controlled study. Skin Pharmacol Physiol 2006; 19: 153–8

    Article  PubMed  CAS  Google Scholar 

  98. Ratnavel RC, Squire RA, Boorman GC. Clinical efficacies of shampoos containing ciclopirox olamine (1.5%) and ketoconazole (2.0%) in the treatment of seborrhoeic dermatitis. J Dermatolog Treat 2007; 18(2): 88–96

    Article  PubMed  CAS  Google Scholar 

  99. Seite S, Rougier A, Malarico S. Randomized study comparing the efficacy and tolerance of a lipohydroxy acid shampoo to a ciclopiroxolamine shampoo in the treatment of scalp seborrheic dermatitis. J Cosmet Dermatol 2009; 8: 249–53

    Article  PubMed  Google Scholar 

  100. Gupta AK, Fleckman P, Baran R. Ciclopirox nail lacquer topical solution 8% in the treatment of toenail onychomycosis. J Am Acad Dermatol 2000; 43 (4 Suppl.): S70–80

    Article  PubMed  CAS  Google Scholar 

  101. Seebacher C, Nietsch KH, Ulbricht HM. A multicenter, open-label study of the efficacy and safety of ciclopirox nail lacquer solution 8% for the treatment of onychomycosis in patients with diabetes [published erratum appears in Cutis 2001; 68(4): 296]. Cutis 2001; 68 (2 Suppl.): 17–22

    Google Scholar 

  102. Brenner MA, Harkless LB, Mendicino RW, et al. Ciclopirox 8% nail lacquer topical solution for the treatment of onychomycosis in patients with diabetes: a multicenter, open-label study. J Am Podiatr Med Assoc 2007; 97(3): 195–202

    PubMed  Google Scholar 

  103. Baran R, Tosti A, Hartmane I, et al. An innovative water-soluble biopolymer improves efficacy of ciclopirox nail lacquer in the management of onychomycosis. J Eur Acad Dermatol Venereol 2009; 23(7): 773–81

    Article  PubMed  CAS  Google Scholar 

  104. Gupta AK, Bluhm R. Ciclopirox (Loprox) gel for superficial fungal infections. Skin Therapy Lett 2004 Aug-Sep; 9: 4–5

    Google Scholar 

  105. Gupta AK, Nicol KA. Ciclopirox 1% shampoo for the treatment of seborrheic dermatitis. Int J Dermatol 2006 Jan; 45(1): 66–9

    Article  PubMed  CAS  Google Scholar 

  106. Ciclopirox olamine: clinical overview. Lugano, Switzerland: Polichem SA, 2008. (Data on file)

  107. Gupta AK, Ryder JE, Baran R. The use of topical therapies to treat onychomycosis. Dermatol Clin 2003; 21: 481–9

    Article  PubMed  CAS  Google Scholar 

  108. Gupta AK, Schouten JR, Lynch LE. Ciclopirox nail lacquer 8% for the treatment of onychomycosis: a Canadian perspective. Skin Therapy Lett 2005 Sep; 10(7): 1–3

    PubMed  CAS  Google Scholar 

  109. Sweetman SC, editor. Martindale: the complete drug reference. 35th ed. London: Pharmaceutical Press, 2007:477

    Google Scholar 

Download references

Acknowledgements

Dr Togni acts as a consultant to Polichem SA, and Dr Mailland is an employee of Polichem SA as its Scientific Director. Drs Subissi and Monti have declared they have no conflicts of interest that are directly relevant to the content of this review.

Author information

Authors and Affiliations

  1. Department of Pharmaceutical Sciences, University of Pisa, Via Bonanno 33, Pisa, I-56100, Italy

    Alessandro Subissi &  Daniela Monti

  2. Department of Microbiology, Unilabs SA, Coppet, Switzerland

    Giuseppe Togni

  3. Scientific Department, Polichem SA, Lugano, Switzerland

    Federico Mailland

Authors
  1. Alessandro Subissi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniela Monti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giuseppe Togni
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Federico Mailland
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniela Monti.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Subissi, A., Monti, D., Togni, G. et al. Ciclopirox. Drugs 70, 2133–2152 (2010). https://doi.org/10.2165/11538110-000000000-00000

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/11538110-000000000-00000

Keywords

  • Terbinafine
  • Dermatophytosis
  • Tinea Pedis
  • Vaginal Candidiasis
  • Ciclopirox