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Oral terbinafine and topical ciclopirox

Discussion in 'General Issues and Discussion Forum' started by LuckyLisfranc, Jan 19, 2006.

  1. LuckyLisfranc

    LuckyLisfranc Well-Known Member


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    Journal of Dermatological Treatment (Onychomycosis)

    Combination of oral terbinafine and topical ciclopirox compared to oral terbinafine for the treatment of onychomycosis.

    Volume 16, Number 5-6 / 01Dec2005

    Abstract:


    Background: Treatment of onychomycosis has recently been enhanced by the introduction of combination therapies. Objective: To evaluate the efficacy of a combination therapy of ciclopirox nail lacquer and oral terbinafine compared to oral terbinafine monotherapy for the treatment of onychomycosis caused by dermatophytes. Patients and methods: Eighty patients with onychomycosis were randomly assigned to receive either oral terbinafine 250 mg/day for 16 weeks or a combination of oral terbinafine 250 mg/day for 16 weeks and topical ciclopirox nail lacquer once daily for 9 months. Both groups were followed up for 9 months from start of treatment. Results: After 9 months of treatment, the mycological cure rates were 22/34 (64.7%) for the terbinafine-only group and 30/34 (88.2%) for the combination therapy group (p<0.05). No significant difference was noted in the complete cure rate. Conclusion: Combination therapy of oral terbinafine and ciclopirox nail lacquer is a safe and more effective treatment for onychomycosis than terbinafine alone, especially in younger patients and in shorter-duration onychomycosis.
     
    Last edited by a moderator: Jan 19, 2006
  2. Berms

    Berms Active Member



    Hi LuckyLisfrank,
    I am familiar with terbinafine as a treatment for onychomycosis, but I have not come across ciclopirox - is there a generic / brand name for this nail lacquer? Is it the same as the old Loceryl nail lacquer? And do you know how expensive is it? :confused:
    Thanks,
    Adam
     
  3. LuckyLisfranc

    LuckyLisfranc Well-Known Member

  4. John Spina

    John Spina Active Member

    An oral(terbenafine) and a topical can work very well in concert.The problem:
    1.People that can benefit from the oral meds are VERY reluctant to take it
    2.Those who do ask for it will often not be candidates for it(I had a patient with Hep C ask me for lamisil....I declined.On the other hand 2 friends of mine who really have no medical issues looked at me ready to shoot daggers when I suggested that lamisil oral would help their situation.)
     
  5. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Terbinafine

    Related Articles

    Safety and efficacy of oral terbinafine in the treatment of onychomycosis: analysis of the elderly subgroup in Improving Results in ONychomycosis-Concomitant Lamisil and Debridement (IRON-CLAD), an open-label, randomized trial.
    Am J Geriatr Pharmacother. 2006 Mar;4(1):1-13
     
  6. John Spina

    John Spina Active Member

    Debridement in and of itself is more pallative than anything else.Add topicals or/and orals and I see that patients can and do get a lot of help.
     
  7. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    An open randomized comparative study to test the efficacy and safety of oral terbinafine pulse as a monotherapy and in combination with topical ciclopirox olamine 8% or topical amorolfine hydrochloride 5% in the treatment of onychomycosis.
    Jaiswal A, Sharma RP, Garg AP.
    Indian J Dermatol Venereol Leprol. 2007 Nov-Dec;73(6):393-6.
     
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