Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
CAPITROL vs ACULAR LS
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Ciclopirox is a hydroxypyridine antifungal agent that inhibits the uptake of essential elements and amino acids, disrupts fungal cell membrane integrity, and chelates polyvalent cations (e.g., Fe3+, Al3+), inhibiting metal-dependent enzymes such as cytochromes and catalase.
Selective COX-2 inhibitor; inhibits prostaglandin synthesis, reducing ocular inflammation and pain.
Topical treatment of seborrheic dermatitis of the scalp in adults
FDA: Treatment of postoperative inflammation in patients who have undergone cataract surgery,Off-label: Relief of ocular pain, photophobia, and inflammation associated with corneal abrasion or refractive surgery
Apply 1 m L of 1% shampoo twice weekly for 4 weeks, then weekly for maintenance. Use on wet hair, lather for 2-3 minutes, rinse thoroughly.
1 drop in the affected eye(s) four times daily
Terminal elimination half-life is 20-40 hours; clinically, steady-state is achieved within 5-7 days.
The terminal elimination half-life is approximately 1.8 hours (range 1.2–2.5 hours) following topical ocular administration. This short half-life is consistent with rapid clearance from the systemic circulation.
Ciclopirox is primarily metabolized via glucuronidation, with less than 2% excreted unchanged in urine. The major metabolite is ciclopirox glucuronide.
Primarily hepatic via CYP2C9; undergoes glucuronidation and oxidation to inactive metabolites.
Primarily renal (approximately 60-70% as unchanged drug); biliary/fecal elimination accounts for about 20-30%.
Renal excretion of metabolites and unchanged drug accounts for approximately 26% of the dose. Fecal excretion accounts for approximately 74% of the dose, primarily as metabolites.
>99% bound to albumin and alpha-1-acid glycoprotein.
Ketorolac is highly protein bound, approximately 99% bound to plasma proteins, primarily albumin.
0.3 L/kg; indicates distribution primarily into extracellular fluid.
The volume of distribution is approximately 0.12 L/kg, indicating distribution primarily into extracellular fluid with limited tissue penetration.
Oral: 70-80%; Topical: approximately 5-10%.
Ophthalmic bioavailability is approximately 2% of the administered dose due to extensive nasolacrimal drainage and systemic absorption. Oral bioavailability of ketorolac is approximately 80-100%, but this route is not used for ophthalmic formulations.
No adjustment required as systemic absorption is negligible.
No dosage adjustment required for renal impairment
No adjustment required as systemic absorption is negligible.
No dosage adjustment required for hepatic impairment but use with caution in severe hepatic disease due to potential for increased systemic exposure
Safety and efficacy not established in children under 12 years; use same as adult for ages 12 and above.
Safety and efficacy in pediatric patients below 2 years of age have not been established; for children 2 years and older, same as adult dosing
No specific dose adjustment; caution with dry or aged skin due to potential irritation.
No specific dose adjustment recommended; use with caution due to increased incidence of age-related ocular conditions
None.
None
Avoid contact with eyes,If irritation or sensitization occurs, discontinue use,Not for oral, ophthalmic, or intravaginal use
Increased risk of bleeding and bleeding-related adverse events due to platelet inhibition,May prolong bleeding time,Cross-sensitivity with aspirin and other NSAIDs,Caution in patients with prior history of corneal epithelial defects or ocular surgery,Not for intraocular injection
Hypersensitivity to ciclopirox or any component of the formulation
Hypersensitivity to ketorolac tromethamine or any component of the formulation,Patients with active peptic ulcer disease, recent GI bleeding, or perforation,Patients with advanced renal disease or at risk for renal failure,Patients with known history of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
No known food interactions when applied topically. However, avoid applying immediately before consuming food to minimize accidental ingestion.
No known food interactions for ophthalmic ketorolac. However, maintain good hydration and nutrition to support corneal healing.
No adequate human studies; animal studies not available. Only minimal systemic absorption occurs with topical scalp application; theoretical risk low. First trimester: unlikely to cause harm due to negligible absorption; however, avoid elective use. Second and third trimesters: no known risks.
Ketorolac tromethamine, the active ingredient in ACULAR LS, is a nonsteroidal anti-inflammatory drug (NSAID). In animal reproduction studies, administration of ketorolac during organogenesis resulted in increased embryofetal mortality, delayed ossification, and increased incidence of skeletal abnormalities at doses less than the maximum recommended human ophthalmic dose. However, systemic exposure following ocular administration is very low. NSAIDs are generally avoided during pregnancy, especially in the third trimester, due to the risk of premature closure of the ductus arteriosus and oligohydramnios. The risk is considered low for ophthalmic use but should be used only if clearly needed.
Minimal systemic absorption; expected to be safe during breastfeeding. M/P ratio not determined. Avoid application to breast area.
It is not known whether ketorolac is excreted in human milk after ophthalmic administration. Systemic levels are low, and following oral administration, ketorolac is excreted in breast milk at low concentrations (M/P ratio approximately 0.37). Due to the potential for adverse effects on the nursing infant, caution should be exercised. The low systemic absorption likely poses minimal risk.
No dose adjustment required; topical use only.
No dosing adjustments are necessary for ophthalmic use during pregnancy due to negligible systemic absorption. Standard dosing (1 drop in the affected eye(s) four times daily) is recommended. Systemic NSAIDs may require dose adjustment due to increased volume of distribution and renal changes, but this does not apply to topical ocular ketorolac.
Capitrol (chloroxine) is a topical antibacterial shampoo indicated for dandruff and seborrheic dermatitis. It is generally used twice weekly for 2 weeks, then as needed. Avoid contact with eyes and mucous membranes. Discontinue if local irritation or allergic reaction occurs.
ACULAR LS (ketorolac tromethamine ophthalmic solution 0.4%) is a nonsteroidal anti-inflammatory drug (NSAID) indicated for the reduction of ocular pain and photophobia following corneal refractive surgery. Use with caution in patients with known bleeding tendencies or those on anticoagulants due to increased risk of ocular bleeding. Avoid concurrent use with other NSAIDs or steroids to minimize corneal adverse effects. Monitor for corneal epithelial breakdown or delayed healing.
Use exactly as directed; do not use more often than prescribed.,Wet hair and scalp thoroughly before applying shampoo.,Massage into scalp and leave on for 2-3 minutes before rinsing.,Avoid contact with eyes; if occurs, rinse thoroughly with water.,Use caution to avoid staining of clothing or jewelry; rinse shampoo off completely.,Consult healthcare provider if condition persists or worsens after 2 weeks.,Inform doctor if you are pregnant, planning to become pregnant, or breastfeeding.
Do not touch the dropper tip to any surface to avoid contamination.,Remove contact lenses before instillation and wait at least 10 minutes before reinserting.,Use only in the affected eye(s) as prescribed; do not use for longer than directed.,Temporary stinging or burning may occur upon instillation.,Report any persistent pain, redness, or visual changes to your doctor immediately.,Avoid driving or operating machinery if vision is blurred after use.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about CAPITROL vs ACULAR LS, answered by our medical review team.
CAPITROL is a Topical Antimicrobial that works by Ciclopirox is a hydroxypyridine antifungal agent that inhibits the uptake of essential elements and amino acids, disrupts fungal cell membrane integrity, and chelates polyvalent cations (e.g., Fe3+, Al3+), inhibiting metal-dependent enzymes such as cytochromes and catalase.. ACULAR LS is a NSAID Ophthalmic that works by Selective COX-2 inhibitor; inhibits prostaglandin synthesis, reducing ocular inflammation and pain.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between CAPITROL and ACULAR LS depend on the specific clinical indication. These are agents from distinct pharmacological classes and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of CAPITROL is: Apply 1 m L of 1% shampoo twice weekly for 4 weeks, then weekly for maintenance. Use on wet hair, lather for 2-3 minutes, rinse thoroughly.. The standard adult dose of ACULAR LS is: 1 drop in the affected eye(s) four times daily. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between CAPITROL and ACULAR LS in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. CAPITROL is classified as Category C. No adequate human studies; animal studies not available. Only minimal systemic absorption occurs with topical scalp application; theoretical risk low. First trimester: unlikely to . ACULAR LS is classified as Category C. Ketorolac tromethamine, the active ingredient in ACULAR LS, is a nonsteroidal anti-inflammatory drug (NSAID). In animal reproduction studies, administration of ketorolac during org. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.