1. Name Of The Medicinal Product
Curanail 5%w/v Medicated Nail Lacquer
2. Qualitative And Quantitative Composition
Curanail 5% nail lacquer contains 5% w/v amorolfine in the form of hydrochloride. Amorolfine is chemically described as cis-4-[(RS)-3[4-(1,1-Dimethylpropyl)phenyl]-2-methylpropyl]-2,6-dimethylmorpholine.
Amorolfine hydrochloride HSE 6.40 %w/w
For a full list of excipients, see section 6.1
3. Pharmaceutical Form
Medicated Nail Lacquer.
4. Clinical Particulars
4.1 Therapeutic Indications
Treatment of mild cases of distal and lateral subungual onychomycoses caused by dermatophytes, yeasts and moulds limited up to 2 nails.
4.2 Posology And Method Of Administration
Adults and Elderly
The nail lacquer should be applied to the affected finger or toe nails once weekly.
The patient should apply the nail lacquer as follows:
1. Before the first application of Curanail 5% nail lacquer, it is essential that the affected areas of nail (particularly the nail surfaces) should be filed down as thoroughly as possible using a nail file. The surface of the nail should then be cleansed and degreased using an alcohol cleaning pad. Before repeat application of Curanail 5% nail lacquer , the affected nails should be filed down again as required, following cleansing with a cleaning pad to remove any remaining lacquer.
Caution: Nail files used for affected nails must not be used for healthy nails.
2. With one of the reusable applicators supplied, apply the nail lacquer to the entire surface of the affected nails and allow it to dry. After use, clean the applicator with the same cleaning pad used before for nail cleaning. Keep the bottle tightly closed.
For each nail to be treated, dip the applicator into the nail lacquer without wiping off any of the lacquer on the bottle neck.
Caution: When working with organic solvents (thinners, white spirit, etc.) wear impermeable gloves in order to protect the Curanail 5% 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 frequency and duration of treatment depends essentially on intensity and localisation of the infection. In general, it is six months (finger nails) and nine to twelve months (toe nails). A review of the treatment is recommended at intervals of approximately three months.
Co-existent tinea pedis should be treated with an appropriate antimycotic cream.
Children
Due to the lack of clinical experience available, Curanail 5% nail lacquer is not recommended for patients below the age of 18 years.
4.3 Contraindications
Curanail 5% nail lacquer must not be reused by patients who have shown hypersensitivity to the active substance or to any of the excipients.
No experience exists of use during pregnancy and nursing, therefore, the use of Curanail 5% nail lacquer should be avoided during pregnancy and lactation.
4.4 Special Warnings And Precautions For Use
Avoid contact of the lacquer with eyes, ears and mucous membranes.
Patients with underlying conditions predisposing to fungal nail infections should be referred to a doctor. Such conditions include peripheral circulatory disorders, diabetes mellitus, and immunosuppression.
Patients with nail dystrophy and destroyed nail plate should be referred to their doctor.
4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction
There are no specific studies involving concomitant treatment with other topical medicines.
Use of nail varnish or artificial nails should be avoided during treatment.
4.6 Pregnancy And Lactation
Reproductive toxicology studies showed no evidence of teratogenicity in laboratory animals but embryotoxicity was observed at high oral doses. The systemic absorption of amorolfine during and after topical administration is very low and therefore the risk to the human foetus appears to be negligible. However, because there is no relevant experience, Curanail 5% nail lacquer should be avoided during pregnancy and breast feeding.
4.7 Effects On Ability To Drive And Use Machines
Not relevant.
4.8 Undesirable 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.
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Contact dermatitis (unknown frequency) has been reported in spontaneous reports.
4.9 Overdose
Accidental oral ingestion
Curanail 5% nail lacquer is for topical use. In the event of accidental oral ingestion, an appropriate method of gastric emptying may be used.
5. Pharmacological Properties
5.1 Pharmacodynamic Properties
Pharmacotherapeutic Group: Other antifungals for topical use ATC code: D01AE16
Curanail 5% nail lacquer is a topical antimycotic. Amorolfine belongs to a new chemical class, and its fungicidal action is based on an alteration of the fungal cell membrane targeted primarily on sterol biosynthesis. The ergosterol content is reduced, and at the same time unusual sterically nonplanar sterols accumulate.
Amorolfine is a broad spectrum antimycotic. It is highly active (MIC < 2mcg/ml) in vitro against
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With the exception of Actinomyces, bacteria are not sensitive to amorolfine. Propionibacterium acnes is only slightly sensitive.
5.2 Pharmacokinetic Properties
Amorolfine from nail lacquer penetrates into and diffuses through the nail plate and is thus able to eradicate poorly accessible fungi in the nail bed. Systemic absorption of the active ingredient is very low with this type of application.
Following prolonged use of Curanail 5% Nail Lacquer, there is no indication of drug accumulation in the body.
5.3 Preclinical Safety Data
None stated.
6. Pharmaceutical Particulars
6.1 List Of Excipients
Ammonio methacrylate copolymer A,
triacetin,
butyl acetate,
ethyl acetate,
ethanol absolute.
6.2 Incompatibilities
Not applicable.
6.3 Shelf Life
3 years.
6.4 Special Precautions For Storage
Curanail 5% nail lacquer should be stored below 30°C. Protect from heat. Keep bottle tightly closed after use.
6.5 Nature And Contents Of Container
Amber glass bottle with screw thread and plastic screw closure.
Pack Size: 3ml
All packs contain spatulas.
6.6 Special Precautions For Disposal And Other Handling
No special requirements.
7. Marketing Authorisation Holder
Galderma (UK) Limited
Meridien House
69-71 Clarendon Road
Watford
Herts
WD17 1DS
UK
8. Marketing Authorisation Number(S)
PL 10590/0049
9. Date Of First Authorisation/Renewal Of The Authorisation
07/04/2006
10. Date Of Revision Of The Text
November 2010
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