Amorolfine (nail lacquer)
 BRAND NAMES
- International: Loceryl nail lacquer 5%
 MECHANISM OF ACTION
Amorolfine nail lacquer is a topical antifungal. Its fungistatic and fungicidal effect is based on an alteration of the fungal cell membrane targeted primarily on ergosterol biosynthesis. Alteration in the membrane sterol content leads to changes in membrane permeability and disruption of key fungal metabolic processes.
Onychomycosis caused by dermatophytes, Candida, and nondermatophytic molds. Onychomycosis is fungal nail infection, the nail becomes thickened and discoloured: white, black, yellow or green.
 DOSAGE FORMS AND STRENGTHS
Amorolfine 5% topical solution nail lacquer
Amorolfine nail lacquer should be applied to affected finger or toenails once or twice weekly.
Amorolfine nail lacquer should be applied to affected finger or toenails once or twice weekly. The patient should apply the nail lacquer as follows: Before the first application of Amorolfine nail lacquer, it is essential that the affected areas of the nail (particularly the nail surface) should be filed down as thoroughly as possible using a disposable nail file (as supplied). The surface of the nail should then be cleansed and degreased using an alcohol soaked swab (as supplied). Before repeat application of Amorolfine nail lacquer, the affected nails should be filed down again as required, and at any rate be cleansed with an alcohol soaked swab to remove any remaining lacquer.
The lacquer is applied to the entire surface of the affected nail(s). For each nail to be treated, the spatula is dipped into the nail lacquer without wiping off any of the lacquer on the bottle neck. The bottle must be tightly closed immediately after application of the lacquer to the nail(s). The nail lacquer is allowed to dry for approximately 3-5 minutes. After use, clean the spatula with the same pre-soaked swab used before for nail cleaning.
When working with organic solvents (thinners, white spirit, etc.) wear impermeable gloves in order to protect the Amorolfine nail lacquer on the nails.
Treatment should be continued without interruption until the nail is regenerated and the affected areas are finally cured. The required duration of treatment depends essentially on intensity and localization of the infection and the growth rate of the nails. In general, it is six months for finger nails and nine to twelve months for toenails.
Caution: Nail files used for affected nails must not be used for healthy nails.
- Hypersensitivity to the active substance or to any of the excipients.
Owing to the lack of clinical experience available to date, children should not be treated with Amorolfine nail lacquer.
No interaction studies have been performed.
 PREGNANCY AND LACTATION
There are no adequate data from the use of amorolfine in pregnant and/or in nursing women. Studies in animals have shown reproductive toxicity. The potential risk for humans is unknown.
Amorolfine nail lacquer should not be used during pregnancy unless clearly necessary.
 SIDE EFFECTS
Adverse drug reactions are rare. Nail disorders (e.g. nail discoloration, broken nails, brittle nails) may occur. These reactions can also be linked to the onychomycosis itself
 RELATED LINKS
|Ergosterol target : Cell membrane target||Azoles (lanosterol 14 alpha-demethylase inhibitors) : Ergosterol inhibitors||Imidazoles||Topical: Bifonazole • Clotrimazole • Econazole • Fenticonazole • Ketoconazole • Isoconazole • Miconazole • Sertaconazole • Tioconazole|
|Triazoles|| Topical: Fluconazole • Terconazole|
Systemic: Fluconazole • Itraconazole • Posaconazole • Voriconazole
|Polyene antimycotics (ergosterol binding; they form pores in the membrane)|| Topical: Nystatin |
Systemic: Amphotericin B
|Allylamines (squalene epoxidase inhibitors) : Ergosterol inhibitors|| Topical: Amorolfine • Naftifine • Terbinafine |
|Echinocandins (β-glucan synthase inhibitors) : Cell wall target||Anidulafungin • Caspofungin • Micafungin|
|Pyrimidine analogues / Thymidylate synthase inhibitors : Nucleic acid inhibitors||Flucytosine|