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Ciclopirox is a hydroxypyridone antifungal that compounding pharmacies prepare as nail solutions, creams, gels, shampoos and combination topical preparations by prescription.
Ciclopirox, often supplied as the olamine salt, is a broad-spectrum hydroxypyridone antifungal. It acts differently from azoles and allylamines: it binds polyvalent metal ions such as iron and aluminum, which shuts down metal-dependent fungal enzymes that break down peroxides and disrupts the cell's energy production. Manufactured products include ciclopirox olamine cream and suspension (the Loprox line and its generics), FDA-approved for tinea pedis, cruris and corporis, cutaneous candidiasis and tinea versicolor; ciclopirox gel, approved for interdigital tinea pedis, tinea corporis and seborrheic dermatitis of the scalp; ciclopirox shampoo (Loprox Shampoo, Bausch Health), approved for seborrheic dermatitis of the scalp in adults; and ciclopirox 8% topical solution nail lacquer (the Penlac product, with generics from Padagis), approved for mild to moderate onychomycosis due to Trichophyton rubrum without lunula involvement. Prescribers may order ciclopirox compounded in another vehicle or strength, or combined with a second antifungal in one nail solution. Compounded preparations are not FDA-approved and require a prescription.
Ciclopirox labels carry no boxed warning. Do not use it if you are allergic to ciclopirox or any component of the preparation. It is for skin, scalp or nails only: keep it out of the eyes, nose, mouth and vagina. The nail solution is flammable, so keep it away from heat and flames, do not use nail polish on treated nails, and have loose infected nail trimmed by a trained professional, especially if you have diabetes or nerve damage in the feet. Lighter hair may discolor with the shampoo. The nail lacquer label advises against using it with oral antifungals for nail infection. Stop and talk to your prescriber or pharmacist for burning, itching, blistering, swelling or redness that persists. The labels list Pregnancy Category B, and it is not known whether ciclopirox passes into breast milk; lactation references note very little is absorbed through skin and advise keeping treated areas away from the infant.
Ciclopirox chelates Fe3+ and Al3+, inhibiting metal-dependent enzymes (cytochromes, catalase, peroxidase), disrupting mitochondrial electron transport and nutrient uptake, and altering membrane permeability. It is fungistatic or fungicidal depending on concentration and contact time and is active against dermatophytes, yeasts including some azole-resistant Candida, Malassezia and some molds, with in vitro activity against Gram-positive and Gram-negative bacteria and an anti-inflammatory effect through 5-lipoxygenase and cyclooxygenase inhibition. Systemic exposure is low: about 1.3 percent of a topically applied ciclopirox solution was absorbed under occlusion, with a half-life of 1.7 hours, under 5 percent of the nail lacquer dose, and under 0.5 percent urinary excretion with the shampoo; glucuronidation is the main metabolic route. Labeled indications are given above by product; cream safety is not established under age 10 and shampoo under age 16. A 2019 review in Indian Dermatology Online Journal reports that the anti-inflammatory activity of ciclopirox olamine 1% cream was similar to that of a ciclopirox-hydrocortisone combination. Vehicle, strength and duration are per prescriber. Monitoring is clinical: response, local irritation and periodic nail debridement. Ciclopirox is not a controlled substance.
Compounded at Bayview
Patient guides for the preparations we make most often. Each one is compounded to order and requires a prescription.
For prescribers
Every preparation in our formulary that contains this ingredient. Strength, base and dose form are set by the prescription.
Ciclopirox is a broad-spectrum antifungal used on the skin for athlete's foot, jock itch, ringworm, yeast rashes, and tinea versicolor, on the scalp for seborrheic dermatitis, and on the nails for fungal infection. Manufactured ciclopirox comes as a 0.77% cream, gel, and lotion, a 1% shampoo, and an 8% nail lacquer. Bayview compounds it when your prescriber wants a higher strength, such as a 6% cream or gel, a 1.5% shampoo or solution, or a nail lacquer in a different vehicle. The compounded preparations are not FDA-approved and are prepared to your prescriber's order.
Other salt forms of this molecule, and ingredients commonly compounded alongside it.
This page describes an active pharmaceutical ingredient, not a finished drug product. Bayview Pharmacy compounds preparations containing it only on a prescriber's order for an individual patient.
Compounded preparations are not FDA-approved, and the FDA has not evaluated them for safety, effectiveness, or manufacturing quality. Nothing on this page is a claim that any preparation is effective for any condition.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Our pharmacists work with prescribers to build preparations around a patient's dose, form and tolerances. Ask us what is possible with this ingredient.
