Comparative Pharmacology
Head-to-head clinical analysis: CICLOPIROX versus LAMISIL AT.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CICLOPIROX versus LAMISIL AT.
CICLOPIROX vs LAMISIL AT
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Ciclopirox is a hydroxypyridone antifungal agent that chelates polyvalent metal cations (e.g., Fe3+, Al3+) inhibiting metal-dependent enzymes, thereby disrupting fungal cellular metabolic processes, including mitochondrial electron transport and energy production.
Terbinafine inhibits squalene epoxidase, an enzyme in the fungal ergosterol biosynthesis pathway. This leads to accumulation of squalene and depletion of ergosterol, disrupting fungal cell membrane integrity and causing cell death.
Ciclopirox 8% nail lacquer: Apply to affected nails once daily for up to 48 weeks. Ciclopirox 1% cream or lotion: Apply to affected skin twice daily for 2-4 weeks. Ciclopirox 1% shampoo: Apply to wet hair, lather, leave for 3 minutes, rinse; use twice weekly for 4 weeks (for seborrheic dermatitis).
Terbinafine 250 mg orally once daily for 6 weeks for fingernail onychomycosis or 12 weeks for toenail onychomycosis. Topical: 1% cream applied once daily for 1 week for tinea pedis; 1% solution applied once daily for 1 week for tinea corporis/cruris.
None Documented
None Documented
Clinical Note
moderateCiclopirox + Tranilast
"The risk or severity of adverse effects can be increased when Ciclopirox is combined with Tranilast."
Clinical Note
moderateCiclopirox + Tolfenamic acid
"The risk or severity of adverse effects can be increased when Ciclopirox is combined with Tolfenamic acid."
Clinical Note
moderateCiclopirox + Nimesulide
"The risk or severity of adverse effects can be increased when Ciclopirox is combined with Nimesulide."
Clinical Note
moderateCiclopirox + Risedronic acid
Terminal elimination half-life: 1.7-3.0 hours in healthy individuals; prolonged in hepatic impairment
The terminal elimination half-life is approximately 11-17 hours in healthy adults; however, it increases to about 200-400 hours in the distribution phase from tissues (e.g., skin, adipose). Steady-state is reached after 10-14 days of oral dosing.
Renal: approximately 70-80% of the absorbed dose as unchanged drug and glucuronide conjugates; biliary/fecal: ~20-30%
Terbinafine is extensively metabolized in the liver; approximately 80% of a dose is excreted in urine as metabolites, and 20% in feces. Less than 1% is excreted unchanged in urine.
Category A/B
Category C
Antifungal
Antifungal
"The risk or severity of adverse effects can be increased when Ciclopirox is combined with Risedronic acid."