Source: FDA, National Drug Code (US) Revision Year: 2016
(To understand fully the indication for this product, please read the entire INDICATIONS AND USAGE section of the labeling.)
PENLAC Nail Lacquer (ciclopirox) Topical Solution, 8%, 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.
The results of use of PENLAC Nail Lacquer (ciclopirox) Topical Solution, 8%, 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% in conjunction with monthly removal of the unattached, infected toenail by the investigator. PENLAC Nail Lacquer (ciclopirox) Topical Solution, 8% 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 | 2 | 0 | 2 | 0 |
Patients with Week 12 Assessments | 4 | 1 | 8 | 0 |
Complete Cure | 3 | 1 | 4 | 0 |
Almost Clear | 2* | 1 | 1* | 0 |
Negative Mycology | 3 | 1 | 5 | 0 |
* Four patients (from studies 312 and 313) who were completely cured did not have post-treatment Week 12 planimetry data.
PENLAC Nail Lacquer (ciclopirox) Topical Solution, 8%, 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).
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.
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 PENLAC Nail Lacquer (ciclopirox) Topical Solution, 8%, is removed with alcohol.
PENLAC Nail Lacquer (ciclopirox) Topical Solution, 8%, should be applied once daily (preferably at bedtime or eight hours before washing) to all affected nails with the applicator brush provided. The PENLAC Nail Lacquer (ciclopirox) Topical Solution, 8%, should be applied evenly over the entire nail plate.
If possible, PENLAC Nail Lacquer (ciclopirox) Topical Solution, 8%, 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 PENLAC Nail Lacquer (ciclopirox) Topical Solution, 8%, 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.
Protect from light (e.g., store the bottle in the carton after every use).
PENLAC Nail Lacquer (ciclopirox) Topical Solution, 8%, should be stored at room temperature between 59° and 86°F (15° and 30°C).
CAUTION: Flammable. Keep away from heat and flame.
© All content on this website, including data entry, data processing, decision support tools, "RxReasoner" logo and graphics, is the intellectual property of RxReasoner and is protected by copyright laws. Unauthorized reproduction or distribution of any part of this content without explicit written permission from RxReasoner is strictly prohibited. Any third-party content used on this site is acknowledged and utilized under fair use principles.