Comparative Pharmacology
Head-to-head clinical analysis: LAMISIL AT versus LOPROX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMISIL AT versus LOPROX.
LAMISIL AT vs LOPROX
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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 is a hydroxypyridone antifungal agent that inhibits metal-dependent enzymes, including cytochromes, by chelating polyvalent cations (Fe3+, Al3+). It disrupts fungal cell membrane integrity and mitochondrial electron transport, leading to fungicidal activity. It also has anti-inflammatory properties by inhibiting prostaglandin and leukotriene synthesis.
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.
Ciclopirox 1% cream or lotion: apply to affected area twice daily. Nail lacquer (8%): apply to affected nails daily. Shampoo (1%): apply 5-10 mL to wet scalp, lather, leave for 3 minutes, rinse; use twice weekly.
None Documented
None Documented
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.
Terminal elimination half-life is approximately 1.7 hours for the absorbed fraction, reflecting rapid renal clearance.
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.
Less than 1% of topically applied ciclopirox is absorbed; absorbed drug is conjugated and excreted renally as glucuronides, with minor fecal elimination.
Category C
Category C
Antifungal
Antifungal