Topical antifungal (hydroxypyridone class)
ATC code: D01AE14 (Ciclopirox)
Brand names
Loprox, Penlac, Ciclodan
Hydroxypyridone with a mechanism distinct from azoles. Chelates trivalent cations (Fe³⁺, Al³⁺) required for fungal cytochrome, catalase and peroxidase activity. Additionally disrupts ATP synthesis and amino acid transport. Broad spectrum: dermatophytes, yeasts (Candida, Malassezia), moulds, gram-positive bacteria. Low systemic absorption with topical use.
First line
First-line topical antimycotic for onychomycosis, dermatophytosis of glabrous skin, tinea versicolor and skin candidiasis. 8% nail lacquer once daily for 6–12 months in onychomycosis with under 50% nail involvement and no matrix involvement. AEMPS positions it as an alternative to systemic terbinafine when contraindicated.
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FDA Category B. Systemic absorption with topical use and nail lacquer is minimal. AEMPS considers use in pregnancy safe; SEGO permits short courses for dermatophytosis.
Compatible. Hale L2. Minimal systemic absorption. When applied to the nipple for dermatophytosis or nipple candidiasis, wipe residue before feeding.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Ciclopirox is evaluated for the following indications with varying evidence strength: Superficial fungal infections (evidence tier A). See the full indication matrix with dosing and citations above on this page.
Common side effects of Ciclopirox (≥ 1 in 100): Burning and itching at the application site, Erythema, Contact dermatitis. See the Safety section for uncommon and serious reactions.
FDA category B. FDA Category B. Systemic absorption with topical use and nail lacquer is minimal. AEMPS considers use in pregnancy safe; SEGO permits short courses for dermatophytosis.
Compatible. Hale L2. Minimal systemic absorption. When applied to the nipple for dermatophytosis or nipple candidiasis, wipe residue before feeding.
Ciclopirox is contraindicated in: Hypersensitivity to ciclopirox; Under 6 years of age (nail lacquer form). Full list in the Safety section.