Table 1.

Postulated antimycotic mechanisms of action of ciclopirox

• Chelation of polyvalent metal cations, especially iron (Fe3+)

Inhibition of metal-dependent enzymes (cytochromes, catalase, and peroxidase)

Disruption of cellular activities such as mitochondrial electron transport processes, energy production, and nutrient intake across the cell membrane

• Alteration of membrane permeability causing blockage of intracellular transport of precursors

• Disruption of DNA repair, cell division signals, and disorganization of internal structures (mitotic spindles) of the fungi

• At higher concentrations, compromising the integrity of the cell membrane of susceptible organisms followed by leakage of potassium ions and other intracellular material

• Inhibitory effect on secreted aspartyl proteinases, important virulence factors for several types of C. albicans infections that favour the adhesion of the yeast to epithelial cells. This may be significant in the action against mucosal candidiasis