Nurses Compass
Drug Guide
Ciclopirox
Classification
Therapeutic: Antifungal
Pharmacological: Imidazole antifungal
FDA Approved Indications
- Superficial fungal infections of the skin (athlete's foot, candidiasis, tinea versicolor)
- Onychomycosis (nail fungus)
Mechanism of Action
Ciclopirox disrupts fungal cell membrane metabolism by inhibiting the transport of essential ions and nutrients, leading to fungal cell death.
Dosage and Administration
Adult: Apply 1-2 times daily for topical formulations; for nail lacquer, apply once daily to affected nails, then weekly after initial period.
Pediatric: Use with caution; consult specific product guidelines.
Geriatric: No specific dose adjustment; monitor for potential skin sensitivity.
Renal Impairment: No specific adjustments necessary for topical use.
Hepatic Impairment: No specific adjustments necessary.
Pharmacokinetics
Absorption: Minimal absorption through intact skin; higher absorption when applied to broken skin.
Distribution: Widely distributed in the skin and nails.
Metabolism: Metabolized minimally; some hepatic metabolism may occur.
Excretion: Excreted primarily in urine, mainly as metabolites.
Half Life: Approximate topical half-life not established; systemic half-life varies with route.
Contraindications
- Hypersensitivity to ciclopirox or any component of the formulation.
Precautions
- Use with caution in patients with damaged skin or open wounds. Not recommended for ophthalmic or intravaginal use unless specified.
Adverse Reactions - Common
- Application site irritation (Common)
- Itching or burning sensation (Common)
Adverse Reactions - Serious
- Allergic contact dermatitis (Rare)
- Severe skin reactions or hypersensitivity (Rare)
Drug-Drug Interactions
- No significant interactions reported with topical use.
Drug-Food Interactions
- None documented.
Drug-Herb Interactions
- No known interactions.
Nursing Implications
Assessment: Evaluate for signs of fungal infection and skin integrity.
Diagnoses:
- Risk for skin irritation or allergic reaction.
Implementation: Apply as directed, avoid contact with eyes or mucous membranes, and instruct patients on proper application.
Evaluation: Monitor for signs of resolution of infection and adverse reactions.
Patient/Family Teaching
- Keep the area clean and dry.
- Apply as prescribed, do not overuse.
- Report any signs of irritation, allergy, or worsening infection.
Special Considerations
Black Box Warnings:
- None
Genetic Factors: No known genetic considerations affecting use.
Lab Test Interference: Minimal to none.
Overdose Management
Signs/Symptoms: Local skin irritation if over-applied.
Treatment: Discontinue use, wash the area with water, and treat symptomatically.
Storage and Handling
Storage: Store at room temperature, away from heat and moisture.
Stability: Stable within expiration date.