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CICLOPIROX 80 mg/mL Solution, 1 bottle — NDC 21922-0053-51 package photo

CICLOPIROX 80 mg/mL Solution, 1 bottle

by Encube Ethicals, Inc. · 1 BOTTLE, WITH APPLICATOR in 1 CARTON (21922-053-51) / 6.6 mL in 1 BOTTLE, WITH APPLICATOR
NDC 21922-0053-51
🏷️ FDA NDC (as labeled) 21922-053-51 billing pads the product segment with a zero
Rx only Generic On market Non-controlled
🗂️ Data synced Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

🆔 Identity & classification

FDA NDC (as labeled) 21922-053-51
Product NDC 21922-053
11-digit billing NDC 21922005351
NCPDP billing unit ML — per mL (volume)
RxCUI 309291
UNII 19W019ZDRJ
Application # ANDA077687
SPL Set ID 79084b47-7481-4926-9837-e08f633b1ddf
Mechanism of action Protein Synthesis Inhibitors
Physiologic effect Decreased DNA Replication; Decreased Protein Synthesis; Decreased RNA Replication
DEA schedule Non-controlled
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2023-11-09
Route TOPICAL
Dosage form SOLUTION
Substance CICLOPIROX
GPI-14 90150030002020
GCN Seq No 037020
GCN 08040
HICL code 016915
Ingredient (HICL) Ciclopirox
HIC1 code Q
Therapeutic class — broad (HIC1) Ear/Eye/Nose/Rectum/Topical/Vagina/Other
HIC2 code Q5
Therapeutic class — intermediate (HIC2) Agents Acting Principally On The Skin
HIC3 code Q5F
Therapeutic class — specific (HIC3) Topical Antifungals
AHFS code 84:04.08.20
AHFS class Hydroxypyridones (Skin, Mucous Membrane)
FDB label name CICLOPIROX 8% SOLUTION
FDB brand name Ciclopirox
Legend status F — Federal legend — prescription drug or device
TE code (Orange Book) AT · RLD · RS
Why two NDCs? The FDA registers this code as 21922-053-51 — a 5-3-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the product segment → 21922-0053-51. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Other antifungals for topical use class.

Drug family (ATC) Other antifungals for topical use, Other antiinfectives and antiseptics
How it works Protein Synthesis Inhibitors
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerEncube Ethicals, Inc.
Application holderENCUBE ETHICALS PRIVATE LTD
FDA applicationANDA077687 (ANDA)
Labeler code21922
First marketedNov 2023
Product typeHuman Prescription Drug
Portfolio77 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name CICLOPIROX 8% SOLUTION Ingredient Ciclopirox
📖 What it is MedlinePlus · NLM

Ciclopirox topical solution is used along with regular nail trimming to treat fungal infections of the fingernails and toenails (an infection that may cause nail discoloration, splitting and pain). Ciclopirox is in a class of medications called antifungals. It works by stopping the growth of nail fungus.

Read the full MedlinePlus article ↗
📗 Our plain-language guide HelloPharmacist
  • Fungal nail infections are slow to clear, and Ciclodan nail lacquer is no exception. In clinical studies, treatment lasted up to 48 weeks. Only a small percentage of patients achie...
  • How long does it take for the nail lacquer to work?
  • No — that's actually one of the most important things to get right. You apply Ciclodan once a day and leave it on. Each new coat goes right on top of the previous one. After seven...
  • Do I need to remove the nail lacquer every night before I apply a new coat?
📖 Read our full Ciclopirox Topical guide →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII 389H2R62BD
    A synthetic polymer made from chemicals that form a plastic-like substance. It acts as a binder and film-former to help hold tablet ingredients together and may provide a protective coating on the medicine.
  • UNII 76845O8NMZ
    Ethyl acetate is a clear, colorless liquid solvent derived from acetic acid and ethanol. In medicines, it dissolves active ingredients, carries them into the product formulation, and helps control how quickly the drug releases and works in your body.
  • UNII ND2M416302
    Isopropyl alcohol is a clear liquid solvent derived from petroleum. In medicines, it dissolves active ingredients and other components, helps the product flow smoothly, and aids in sterilization during manufacturing.

3 inactive ingredients listed in the exact product block matched to this NDC.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMedingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer mLPer package
Retail pharmacies payNADAC · weekly $1.172 $7.73 / 6.6 ml
Medicaid paysCMS SDUD · 12 mo $2.98 $19.65 / 6.6 ml
Medicare drug plans payPart D · Q2 2026 $3.03 $20.03 / 6.6 ml
NADAC price history (per mL) — tap or hover for the price & month
Jan 2024 Jan 2026 Apr 2026 Aug 2026 $2.002 $1.172
▼ Down 41% over the last 11 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Ciclopirox 80 mg/mLthis 21922-0053-51 Encube 1 bottle $1.172 AT Availability likely
Ciclopirox 80 mg/mL 42192-0715-06 Acella 1 bottle $1.172 AT Availability likely
Ciclopirox 80 mg/mL 45802-0141-67 Padagis 1 bottle $1.172 AT Availability likely
Ciclopirox 42192-0714-01 Acella 1 kit $7.355 Availability likely +528%
Ciclopirox 80 mg/mL 50090-6562-00 A-S 1 bottle AT FDA listed
Ciclopirox 71.3 mg/mL 62135-0814-45 Chartwell 6.6 ml AT FDA listed
Ciclopirox 80 mg/mL 63629-8623-01 Bryant 1 bottle AT FDA listed
Ciclopirox 80 mg/mL 68788-6797-06 Preferred 1 bottle AT FDA listed
Ciclopirox 80 mg/mL 68788-8755-06 Preferred 1 bottle AT FDA listed
Ciclopirox 80 mg/mL 71335-2836-01 Bryant 1 bottle AT FDA listed
Ciclopirox 80 mg/mL 72162-1321-02 Bryant 1 bottle AT FDA listed
Ciclopirox 80 mg/mL 72162-2076-01 Bryant 1 bottle AT FDA listed
Ciclopirox 80 mg/mL 72162-2298-02 Bryant 1 bottle AT FDA listed
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
2023
On the market since
Nov 2023
📍
2026
Currently FDA-listed
3 years listed
🔓
·
Generic on the market
this product is a generic
This is a generic drug

This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

🗺️ Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for 21922-0053-51, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q4 2025 · 4 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
139.6K
Units reimbursed last 4 qtrs
934.4K
Gross reimbursed last 4 qtrs
$2.78M
Avg / prescription
$19.92
Avg / unit
$2.9767
Latest quarter Q4 2025
37.2KRx
Medicaid pays / mL
$2.9767
gross reimbursed
vs
NADAC / mL
$1.1718
acquisition cost
=
Spread
+$1.8049
+154% vs cost
What Medicaid paid per mL (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care
51% FFS 49% MCO
Fee-for-service · 71,784 Rx Managed care · 67,836 Rx
State Medicaid map
Alaska: 211 units · 28.8 per 100k residents AK Maine: 455 units · 32.6 per 100k residents ME Washington: 2,812 units · 36.0 per 100k residents WA Idaho: 1,280 units · 65.2 per 100k residents ID Montana: 529 units · 46.7 per 100k residents MT North Dakota: 79 units · 10.1 per 100k residents ND Minnesota: 11,695 units · 204 per 100k residents MN Wisconsin: 11,167 units · 189 per 100k residents WI Michigan: 31,363 units · 312 per 100k residents MI New York: 159,367 units · 814 per 100k residents NY Vermont: 970 units · 150 per 100k residents VT New Hampshire: 185 units · 13.2 per 100k residents NH Oregon: 423 units · 10.0 per 100k residents OR Nevada: 9,511 units · 298 per 100k residents NV Wyoming: no data reported WY South Dakota: 396 units · 43.1 per 100k residents SD Iowa: 4,871 units · 152 per 100k residents IA Illinois: 3,181 units · 25.3 per 100k residents IL Indiana: 12,685 units · 185 per 100k residents IN Ohio: 45,679 units · 388 per 100k residents OH Pennsylvania: 51,174 units · 395 per 100k residents PA New Jersey: 62,119 units · 669 per 100k residents NJ Massachusetts: 31,869 units · 455 per 100k residents MA California: 259,057 units · 665 per 100k residents CA Utah: 1,245 units · 36.4 per 100k residents UT Colorado: 7,249 units · 123 per 100k residents CO Nebraska: 224 units · 11.3 per 100k residents NE Missouri: no data reported MO Kentucky: 9,428 units · 208 per 100k residents KY West Virginia: no data reported WV Virginia: 26,927 units · 309 per 100k residents VA Maryland: 16,315 units · 264 per 100k residents MD Connecticut: 11,563 units · 320 per 100k residents CT Rhode Island: 6,811 units · 622 per 100k residents RI Arizona: 17,424 units · 234 per 100k residents AZ New Mexico: 3,623 units · 171 per 100k residents NM Kansas: 1,221 units · 41.5 per 100k residents KS Arkansas: no data reported AR Tennessee: 5,966 units · 83.7 per 100k residents TN North Carolina: 24,697 units · 228 per 100k residents NC South Carolina: 5,491 units · 102 per 100k residents SC Delaware: 2,996 units · 291 per 100k residents DE Oklahoma: no data reported OK Louisiana: 7,505 units · 164 per 100k residents LA Mississippi: 1,465 units · 49.8 per 100k residents MS Alabama: 1,756 units · 34.4 per 100k residents AL Georgia: 1,439 units · 13.0 per 100k residents GA D.C.: 1,076 units · 158 per 100k residents DC Hawaii: 917 units · 63.9 per 100k residents HI Texas: 6,178 units · 20.3 per 100k residents TX Florida: 71,755 units · 317 per 100k residents FL
Units reimbursed · per 100k residents
10.0814
gray = no data reported
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 New York 814 /100k
2 New Jersey 669 /100k
3 California 665 /100k
4 Rhode Island 622 /100k
5 Massachusetts 455 /100k
6 Pennsylvania 395 /100k
7 Ohio 388 /100k
8 Connecticut 320 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

📊 Medicare Part D spend CMS · PART D · 2026 (Q1)

Medicare Part D (outpatient prescription) spending for Ciclopirox — the program that covers self-administered drugs. 9 manufacturers.
⚠️ Drug-level data: CMS publishes Part D spending by drug, not by NDC — these figures combine every manufacturer, strength and package size sold under the name Ciclopirox. That’s a different level of aggregation than the Medicaid card above, which is specific to this exact 11-digit NDC (pack size included), so the two aren’t directly comparable.
Period
Total Part D spend
$6.35M
Claims incl. refills
257.1K
Beneficiaries
197.4K
Spend / beneficiary
$32.18
Spend / claim
$24.71
Trend by period
💵 About the dollar figures: spending is what Part D plans paid before confidential manufacturer rebates, so the program’s real net cost is lower. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part D Spending by Drug (data.cms.gov), updated quarterly.

🔬 Reported adverse events (FAERS)

Read carefully: FAERS reports are voluntary and unverified. Counts are not incidence, do not establish causation, are subject to reporting bias, and cannot be used to compare one drug to another. Shown for signal context only. Reports for Ciclopirox — the ingredient across all brands.

Top reported reactions

Fatigue181
Pain170
Diarrhoea147
Pruritus135
Rash135
Headache133
Dyspnoea115

Age at onset

Neonate1
Child3
Adolescent4
Adult390
Elderly286

Reporter sex

2,937 reports
Male · 45%
Female · 55%
Unknown · 0%

Serious outcomes

Hospitalization763
Death110
Life-threatening71
Disabling62
Reports over time (by year) — tap or hover for the count & year
2024 2025 2026 318 160
Most recent year is provisional (FAERS lags ~3 months).
Where does this data come from?
Adverse-event reports from the FDA Adverse Event Reporting System (FAERS) via openFDA. FAERS reports are voluntary and unverified — counts are not incidence and don’t establish causation.

📦 Packaging — all sizes for this product

Package NDCDescription Marketing startStatus
21922-0053-51 You're viewing this 1 BOTTLE, WITH APPLICATOR in 1 CARTON (21922-053-51) / 6.6 mL in 1 BOTTLE, WITH APPLICATOR 2023-11-09 Active

📄 Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage ~3 min read

INDICATIONS AND USAGE (To understand fully the indication for this product, please read the entire INDICATIONS AND USAGE section of the labeling.) Ciclopirox topical solution, 8% (nail lacquer), as a component of a comprehensive management program, is indicated as topical treatment in immunocompetent patients with mild to moderate onychomycosis of fingernails and toenails without lunula involvement, due to Trichophyton rubrum . The comprehensive management program includes removal of the unattached, infected nails as frequently as monthly, by a health care professional who has special competence in the diagnosis and treatment of nail disorders, including minor nail procedures.

No studies have been conducted to determine whether ciclopirox might reduce the effectiveness of systemic antifungal agents for onychomycosis. Therefore, the concomitant use of ciclopirox topical solution, 8% (nail lacquer) and systemic antifungal agents for onychomycosis, is not recommended. Ciclopirox topical solution, 8% (nail lacquer), should be used only under medical supervision as described above.

The effectiveness and safety of ciclopirox topical solution, 8% (nail lacquer), in the following populations has not been studied. The clinical trials with use of ciclopirox topical solution, 8% (nail lacquer), excluded patients who: were pregnant or nursing, planned to become pregnant, had a history of immunosuppression (e.g., extensive, persistent, or unusual distribution of dermatomycoses, extensive seborrheic dermatitis, recent or recurring herpes zoster, or persistent herpes simplex), were HIV seropositive, received organ transplant, required medication to control epilepsy, were insulin dependent diabetics or had diabetic neuropathy.

Patients with severe plantar (moccasin) tinea pedis were also excluded. The safety and efficacy of using ciclopirox topical solution, 8% (nail lacquer), daily for greater than 48 weeks have not been established. Clinical Trials Data The results of use of ciclopirox topical solution, 8% (nail lacquer), in treatment of onychomycosis of the toenail without lunula involvement were obtained from two double-blind, placebo-controlled studies conducted in the US.

In these studies, patients with onychomycosis of the great toenails without lunula involvement were treated with ciclopirox topical solution, 8% (nail lacquer), in conjunction with monthly removal of the unattached, infected toenail by the investigator. Ciclopirox topical solution, 8% (nail lacquer), was applied for 48 weeks. At baseline, patients had 20-65% involvement of the target great toenail plate.

Statistical significance was demonstrated in one of two studies for the endpoint “complete cure” (clear nail and negative mycology), and in two studies for the endpoint “almost clear” ( < 10% nail involvement and negative mycology) at the end of study. These results are presented below. At Week 48 (plus Last Observation Carried Forward) for the Intent-to-Treat (ITT) Population Study 312 Study 313 Active Vehicle Active Vehicle Complete Cure* 6/110 (5.5%) 1/109 (0.9%) 10/118 (8.5%) 0/117 (0%) Almost Clear** 7/107 (6.5%) 1/108 (0.9%) 14/116 (12%) 1/115 (0.9%) Negative Mycology Alone*** 30/105 (29%) 12/106 (11%) 41/115 (36%) 10/114 (9%) * Clear nail and negative mycology ** ≤10% nail involvement and negative mycology *** Negative KOH and negative culture The summary of reported patient outcomes for the ITT population at 12 weeks following the end of treatment are presented below.

Note that post - treatment efficacy assessments were scheduled only for patients who achieved a complete cure. Post-treatment Week 12 Data for Patients Who Achieved Complete Cure at Week 48 Study 312 Study 313 Active Vehicle Active Vehicle Number of Treated Patients 112 111 119 118 Complete Cure at Week 48 6 1 10 0 Post-treatment Week 12 Outcomes: Patients Missing All Week 12 Assessments Patients with Week 12 Assessments Complete Cure Almost Clear Negative Mycology 2 4 3 2* 3 0 1 1 1 1 2 8 4 1* 5…

⏱️ Dosage and Administration ~1 min read

DOSAGE AND ADMINISTRATION Ciclopirox topical solution, 8% (nail lacquer), should be used as a component of a comprehensive management program for onychomycosis. Removal of the unattached, infected nail, as frequently as monthly, by a health care professional, weekly trimming by the patient, and daily application of the medication are all integral parts of this therapy. Careful consideration of the appropriate nail management program should be given to patients with diabetes (see PRECAUTIONS ).

Nail Care By Health Care Professionals Removal of the unattached, infected nail, as frequently as monthly, trimming of onycholytic nail, and filing of excess horny material should be performed by professionals trained in treatment of nail disorders. Nail Care By Patient Patients should file away (with emery board) loose nail material and trim nails, as required, or as directed by the health care professional, every seven days after ciclopirox topical solution, 8% (nail lacquer), is removed with alcohol. Ciclopirox topical solution, 8% (nail lacquer), should be applied once daily (preferably at bedtime or eight hours before washing) to all affected nails with the applicator brush provided.

The ciclopirox topical solution, 8% (nail lacquer), should be applied evenly over the entire nail plate. If possible, ciclopirox topical solution, 8% (nail lacquer), should be applied to the nail bed, hyponychium, and the under surface of the nail plate when it is free of the nail bed (e.g., onycholysis). The ciclopirox topical solution, 8% (nail lacquer), should not be removed on a daily basis.

Daily applications should be made over the previous coat and removed with alcohol every seven days. This cycle should be repeated throughout the duration of therapy.

Contraindications 20 words

CONTRAINDICATIONS Ciclopirox topical solution, 8% (nail lacquer), is contraindicated in individuals who have shown hypersensitivity to any of its components.

⚠️ Warnings 24 words

WARNINGS Ciclopirox topical solution, 8% (nail lacquer), is not for ophthalmic, oral, or intravaginal use. For use on nails and immediately adjacent skin only.

🤒 Adverse Reactions ~2 min read

ADVERSE REACTIONS In the vehicle-controlled clinical trials conducted in the US, 9% (30/327) of patients treated with ciclopirox topical solution, 8% (nail lacquer), and 7% (23/328) of patients treated with vehicle reported treatment-emergent adverse events (TEAE) considered by the investigator to be causally related to the test material. The incidence of these adverse events, within each body system, was similar between the treatment groups except for Skin and Appendages: 8% (27/327) and 4% (14/328) of subjects in the ciclopirox and vehicle groups reported at least one adverse event, respectively.

The most common were rash-related adverse events: periungual erythema and erythema of the proximal nail fold were reported more frequently in patients treated with ciclopirox topical solution, 8% (nail lacquer), (5% [16/327]) than in patients treated with vehicle (1% [3/328]). Other TEAEs thought to be causally related included nail disorders such as shape change, irritation, ingrown toenail, and discoloration. The incidence of nail disorders was similar between the treatment groups (2% [6/327] in the ciclopirox topical solution, 8% (nail lacquer), group and 2% [7/328] in the vehicle group).

Moreover, application site reactions and/or burning of the skin occurred in 1 % of patients treated with ciclopirox topical solution, 8% (nail lacquer), (3/327) and vehicle (4/328). A21-Day Cumulative Irritancy study was conducted under conditions of semi-occlusion. Mild reactions were seen in 46% of patients with the ciclopirox topical solution, 8% (nail lacquer), 32% with the vehicle and 2% with the negative control, but all were reactions of mild transient erythema.

There was no evidence of allergic contact sensitization for either the ciclopirox topical solution, 8% (nail lacquer), or the vehicle base. In a separate study of the photosensitization potential of ciclopirox topical solution, 8% (nail lacquer), in a maximized test design that included the occluded application of sodium lauryl sulfate, no photoallergic reactions were noted. In four subjects localized allergic contact reactions were observed.

In the vehicle-controlled studies, one patient treated with ciclopirox topical solution, 8% (nail lacquer), discontinued treatment due to a rash, localized to the palm (causal relation to test material undetermined). Use of ciclopirox topical solution, 8% (nail lacquer), for 48 additional weeks was evaluated in an open-label extension study conducted in patients previously treated in the vehicle-controlled studies. Three percent (9/281) of subjects treated with ciclopirox topical solution, 8% (nail lacquer), experienced at least one TEAE that the investigator thought was causally related to the test material.

Mild rash in the form of periungual erythema (1% [2/281]) and nail disorders (1 % [4/281]) were the most frequently reported. Four patients discontinued because of TEAEs. Two of the four had events considered to be related to test material: one patient’s great toenail “broke away” and another had an elevated creatine phosphokinase level on Day 1 (after 48 weeks of treatment with vehicle in the previous vehicle-controlled study).

🤰 Pregnancy 104 words

Pregnancy Teratogenic effects: Pregnancy Category B Teratology studies in mice, rats, rabbits, and monkeys at oral doses of up to 77, 23, 23, or 38.5 mg, respectively, of ciclopirox as ciclopirox olamine/kg/day (14, 8, 17, and 28 times MRHTD), or in rats and rabbits receiving topical doses of up to 92.4 and 77 mg/kg/day, respectively (33 and 55 times MRHTD), did not indicate any significant fetal malformations. There are no adequate or well-controlled studies of topically applied ciclopirox in pregnant women. Ciclopirox topical solution, 8% (nail lacquer), should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

🧒 Pediatric Use 36 words

Pediatric Use Based on the safety profile in adults, ciclopirox topical solution, 8% (nail lacquer), is considered safe for use in children twelve years and older. No clinical trials have been conducted in the pediatric population.

🧓 Geriatric Use 46 words

Geriatric Use Clinical studies of ciclopirox topical solution, 8% (nail lacquer), did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between elderly and younger patients.

🧬 Clinical Pharmacology ~3 min read

CLINICAL PHARMACOLOGY Microbiology Mechanism of Action The mechanism of action of ciclopirox has been investigated using various in vitro and in vivo infection models. One in vitro study suggested that ciclopirox acts by chelation of polyvalent cations (Fe +3 or Al +3 ) resulting in the inhibition of the metal-dependent enzymes that are responsible for the degradation of peroxides within the fungal cell. The clinical significance of this observation is not known.

Activity in vitro and ex vivo In vitro methodologies employing various broth or solid media with and without additional nutrients have been utilized to determine ciclopirox minimum inhibitory concentration (MIC) values for the dermatophytic molds. (1-2) As a consequence, a broad range of MIC values, 1-20 μg/mL, were obtained for Trichophyton rubrum and Trichophyton mentagrophytes species. Correlation between in vitro MIC results and clinical outcome has yet to be established for ciclopirox.

One ex vivo study was conducted evaluating 8% ciclopirox against new and established Tricho phyton rubrum and Trichophyton mentagrophytes infections in ovine hoof material. (3) After 10 days of treatment the growth of T. rubrum and T. mentagrophytes in the established infection model was very minimally affected. Elimination of the molds from hoof material was not achieved in either the new or established infection models.

Susceptibility testing for Trichophyton rubrum species In vitro susceptibility testing methods for determining ciclopirox MIC values against the dermatophytic molds, including Trichophyton rubrum species, have not been standardized or validated. Ciclopirox MIC values will vary depending on the susceptibility testing method employed, composition and pH of media and the utilization of nutritional supplements. Breakpoints to determine whether clinical isolates of Trichophyton rubrum are susceptible or resistant to ciclopirox have not been established.

Resistance Studies have not been conducted to evaluate drug resistance development in T. rubrum species exposed to 8% ciclopirox topical solution. Studies assessing cross-resistance to ciclopirox and other known antifungal agents have not been performed. Antifungal Drug Interactions No studies have been conducted to determine whether ciclopirox might reduce the effectiveness of systemic antifungal agents for onychomycosis.

Therefore, the concomitant use of 8% ciclopirox topical solution and systemic antifungal agents for onychomycosis is not recommended. Pharmacokinetics As demonstrated in pharmacokinetic studies in animals and man, ciclopirox olamine is rapidly absorbed after oral administration and completely eliminated in all species via feces and urine. Most of the compound is excreted either unchanged or as glucuronide.

After oral administration of 10 mg of radiolabeled drug (14C-ciclopirox) to healthy volunteers, approximately 96% of the radioactivity was excreted renally within 12 hours of administration. Ninety-four percent of the renally excreted radioactivity was in the form of glucuronides. Thus, glucuronidation is the main metabolic pathway of this compound.

Systemic absorption of ciclopirox was determined in 5 patients with dermatophytic onychomycoses, after application of ciclopirox topical solution, 8% (nail lacquer), to all 20 digits and adjacent 5 mm of skin once daily for six months. Random serum concentrations and 24 hour urinary excretion of ciclopirox were determined at two weeks and at 1, 2, 4 and 6 months after initiation of treatment and 4 weeks post-treatment. In this study, ciclopirox serum levels ranged from 12-80 ng/mL.

Based on urinary data, mean absorption of ciclopirox from the dosage form was <5% of the applied dose. One month after cessation of treatment, serum and urine levels of ciclopirox were below the limit of detection. In two vehicle-controlled trials, patients applied ciclopirox topical solution, 8% (nail lacquer) to all toenails and affected fingernails.

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📦 How Supplied / Storage and Handling 186 words

HOW SUPPLIED Ciclopirox topical solution, 8% (nail lacquer), is supplied in 6.6 mL (NDC 21922-053-51) glass bottles with screw caps which are fitted with brushes. Protect from light (e.g., store the bottle in the carton after every use). Ciclopirox topical solution, 8% (nail lacquer), should be stored at 20°C to 25°C (68°F to 77°F) [see USP Controlled Room Temperature.] CAUTION: Flammable.

Keep away from heat and flame. Rx ONLY To report SUSPECTED ADVERSE REACTIONS, contact Encube Ethicals Private Limited at 1-833-285-4151 and/or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. Made in Finland Manufactured by: Encube Ethicals Pvt.

Ltd. Plot No. C-1, Madkaim Industrial Estate, Madkaim, Post: Mardol, Panda, Goa-403404, India.

References: 1. Dittmar W., Lohaus G. 1973.

HOE296, A new antimycotic compound with a broad antimicrobial spectrum. Arzneim-Forsch./ Drug Res. 23:670-674.

2. Niewerth et. al., 1998. Antimicrobial susceptibility testing of dermatophytes: Comparison of the agar macrodilution and broth micro dilution tests.

Chemotherapy. 44:31-35. 3.

Yang et. al. 1997. A new simulation model for studying in vitro topical penetration of antifungal drugs into hard keratin.

J. Mycol. Med.

7:195-98. Gantrez is a registered trademark of GAF Corporation Rev. 01/25

📋 Description 123 words

DESCRIPTION Ciclopirox topical solution, 8% (nail lacquer) contains a synthetic antifungal agent, ciclopirox. It is intended for topical use on fingernails and toenails and immediately adjacent skin. Each gram of ciclopirox topical solution, 8% (nail lacquer) contains 80 mg ciclopirox in a solution base consisting of ethyl acetate, NF; isopropyl alcohol, USP; and butyl monoester of poly[methylvinyl ether/maleic acid] in isopropyl alcohol.

Ethyl acetate and isopropyl alcohol are solvents that vaporize after application. Ciclopirox topical solution, 8% (nail lacquer) is a clear, colorless to slightly yellowish solution. The chemical name for ciclopirox is 6-cyclohexyl-1-hydroxy-4- methyl-2(1 H)-pyridone, with the empirical formula C 12 H 17 NO 2 and a molecular weight of 207.27.

The CAS Registry Number is [29342-05-0]. The chemical structure is: Structure

💬 Information for Patients ~2 min read

Information for Patients Patients should have detailed instructions regarding the use of ciclopirox topical solution, 8% (nail lacquer), as a component of a comprehensive management program for onychomycosis in order to achieve maximum benefit with the use of this product. The patient should be told to: 1. Use ciclopirox topical solution, 8% (nail lacquer), as directed by a health care professional.

Avoid contact with the eyes and mucous membranes. Contact with skin other than skin immediately surrounding the treated nail(s) should be avoided. Ciclopirox topical solution, 8% (nail lacquer), is for external use only.

2. Ciclopirox topical solution, 8% (nail lacquer), should be applied evenly over the entire nail plate and 5 mm of surrounding skin. If possible, ciclopirox topical solution, 8% (nail lacquer), should be applied to the nail bed, hyponychium, and the under surface of the nail plate when it is free of the nail bed (e.g., onycholysis).

Contact with the surrounding skin may produce mild, transient irritation (redness). 3. Removal of the unattached, infected nail, as frequently as monthly, by a health care professional is needed with use of this medication.

Inform a health care professional if they have diabetes or problems with numbness in your toes or fingers for consideration of the appropriate nail management program. 4. Inform a health care professional if the area of application shows signs of increased irritation (redness, itching, burning, blistering, swelling, oozing).

5. Up to 48 weeks of daily applications with ciclopirox topical solution, 8% (nail lacquer), and professional removal of the unattached, infected nail, as frequently as monthly, are considered the full treatment needed to achieve a clear or almost clear nail (defined as 10% or less residual nail involvement). 6.

Six months of therapy with professional removal of the unattached, infected nail may be required before initial improvement of symptoms is noticed. 7. A completely clear nail may not be achieved with use of this medication.

In clinical studies less than 12% of patients were able to achieve either a completely clear or almost clear toenail. 8. Do not use the medication for any disorder other than that for which itis prescribed.

9. Do not use nail polish or other nail cosmetic products on the treated nails. 10.

Avoid use near heat or open flame, because product is flammable.

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.