II. Indications

  1. Dermatophyte Infection (Tinea Corporis, Tinea Pedis, Tinea Cruris)
  2. Cutaneous Candidiasis
  3. Tinea Versicolor
  4. Onychomycosis
    1. Not recommended (low efficacy and a very long course)

III. Mechanism

  1. Broad-spectrum Antifungal activity
  2. Antifungal for dermatophytes and yeast
  3. Some antibacterial activity in vitro
    1. Gram Positive Bacteria
    2. Gram Negative Bacteria

IV. Medications

  1. Cutaneous dermatophytes
    1. Ciclopirox Shampoo 1% (Loprox)
    2. Ciclopirox Lotion, Cream or Gel: 0.77%
  2. Onychomycosis (Penlac)
    1. Ciclopirox 8% lacquer (Penlac)

V. Dosing: Adults and Age >12 years old

  1. Dermatophyte Infection (Tinea Corporis, Tinea Pedis, Tinea Cruris, Tinea Versicolor) and Cutaneous Candidiasis
    1. Apply twice daily
  2. Onychomycosis (not recommended; low efficacy and a very long course)
    1. Apply daily to affected nails (over the top of prior application)
    2. Remove with Alcohol every 7 days
    3. Requires 48 week application
  3. Seborrheic Dermatitis
    1. Shampoo twice weekly for 4 weeks
    2. Avoid eye exposure to Shampoo
    3. Light colored hair may be discolored

VI. Safety

  1. Pregnancy Category B
  2. Unknown safety in Lactation

VII. Efficacy

  1. Tinea Pedis (Loprox)
    1. More effective than OTC Clotrimazole (Lotrimin)
  2. Onychomycosis (Penlac)
    1. NOT recommended
    2. Requires 48 week application
    3. Minimally better than Placebo for cure rates
    4. Partial clearance rates are also poor

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Cost: Medications

ciclopirox (on 10/19/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
CICLOPIROX 0.77% CREAM Generic $0.21 per gram
CICLOPIROX 0.77% GEL Generic $0.70 per gram
CICLOPIROX 0.77% TOPICAL SUSP Generic $0.90 per ml
CICLOPIROX 1% SHAMPOO Generic $0.36 per ml
CICLOPIROX 8% SOLUTION Generic $1.70 per ml