0

Home > Drug Category > Anti-Fungal > Curanail and Equivalent

Curanail (Amorolfine) Information

Curanail (amorolfine) is a topical antifungal agent belonging to the morpholine class of chemicals. It is typically formulated as a 5% nail lacquer. It is indicated for the treatment of mild to moderate onychomycosis (fungal nail infection) caused by dermatophytes, yeasts, and moulds, often affecting the toenails and fingernails. Curanail 5% nail lacquer is available over-the-counter (without a prescription) in Canada and many other regions for adults. It is designed to penetrate the hard nail plate and the nail bed where the fungal infection resides. It is applied directly to the infected nail once a week. It requires a long treatment duration—typically six months for fingernails and nine to twelve months for toenails—reflecting the slow growth rate of the nail and the persistent nature of the infection.

The mechanism of action for amorolfine involves disrupting the integrity of the fungal cell membrane, leading to fungal death. Amorolfine achieves this by blocking key steps in the production of ergosterol, the primary fatty substance required to build the fungal cell wall. Specifically, the drug has a unique, multi-target action: it interferes with the enzymes delta-14-sterol reductase and delta-7-8 isomerase, and in some fungal species, it also inhibits squalene epoxidase. By preventing the fungus from making vital ergosterol, amorolfine causes the accumulation of an abnormal, toxic sterol called ignosterol within the fungal cell membrane. This profoundly disrupts the membrane's structure, permeability, and function, thereby achieving a broad-spectrum fungicidal (killing) effect. Because Curanail is a topical lacquer, systemic absorption is extremely low, limiting the potential for widespread drug interactions or systemic side effects.

Curanail Side Effects

As a topical nail lacquer, Curanail's side effects are generally confined to the immediate treatment area. Common side effects are localized, mild, and often rare, including minor burning, itching, or stinging sensations, as well as erythema (redness) of the skin immediately surrounding the nail after application. The nail itself may appear discoloured or brittle. However, it is difficult to attribute this solely to the medication, as it is also a symptom of the underlying fungal infection (onychodystrophy). However, more serious side effects can occur, although they are scarce due to the minimal systemic absorption of the drug. Suppose any of the following symptoms are experienced. In that case, the patient should stop applying the medication, remove the lacquer, and seek immediate medical attention:

• Allergic Contact Dermatitis: A delayed hypersensitivity reaction characterized by severe skin irritation, blistering, or acute inflammation/swelling of the skin surrounding the treated nail.

• Hypersensitivity/Systemic Allergic Reaction: Although infrequent, systemic reactions (e.g., facial swelling, swelling of the lips, tongue, or throat, generalized rash, or difficulty breathing) are possible in highly sensitive individuals.

• Nail Dystrophy/Deterioration: In rare cases, the use of the lacquer may be associated with more severe nail damage, such as significant discolouration, breakage, or detachment of the nail plate (onycholysis).

Curanail Precautions

Curanail (amorolfine) is for external use on the nails only and must not be used on the skin around the nail, eyes, ears, or mucous membranes. Before each application, it is crucial to correctly prepare the nail by filing away the infected areas and cleaning the nail surface with a provided alcohol swab. This swab serves to clean and degrease the nail, and critically, to remove the residue of the previous week’s lacquer layer, which is necessary for effective drug penetration with the new dose. Because the lacquer contains ethanol (alcohol), it is flammable. It must be kept away from heat, open flames, or any source of ignition, including a lighted cigarette or hair dryer, during application and while drying. Patients must not use nail files on infected nails to prevent spreading the infection, and artificial nails must not be used during treatment. While patients must wear impermeable gloves when handling organic solvents (like paint thinner or white spirit) to prevent the solvents from removing the lacquer, cosmetic nail polish can be used—but only applied at least 10 minutes after Curanail has dried. It must be removed entirely (using a non-acetone remover) before the next Curanail application. A doctor must be consulted if the infection involves more than two nails or if the disease is widespread/severe (affecting more than two-thirds of the nail). Consultation is also required if there is no improvement after three months of treatment, or if the patient suffers from diabetes, a weakened immune system, or poor blood circulation in the hands and feet. Finally, Curanail is generally not recommended for use in children, or in pregnant or breastfeeding women, and should only be used in these groups under a healthcare professional's direct supervision.

Do I need a prescription to order Curanail?

Yes, a prescription is required from your physician to order Curanail.