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Penlac vs Jublia
Introduction
For patients who are dealing with onychomycosis, a fungal infection that affects the nails, certain medications can help in managing symptoms and eradicating the fungus. Penlac and Jublia are two such drugs prescribed for this condition. They each inhibit different enzymes critical to fungal cell wall synthesis but both have effective antifungal properties.
Penlac (ciclopirox) is a hydroxypyridone antifungal agent that works by chelating polyvalent cations (Fe3+ or Al3+) resulting in inhibition of the metal-dependent enzymes responsible for degradation of peroxides within the fungal cell. On the other hand, Jublia (efinaconazole) is classified as an azole antifungal—specifically part of subclass triazoles—which work primarily by inhibiting lanosterol 14α-demethylase involved in ergosterol production thus disrupting cell membrane synthesis.
Both medications show efficacy against onychomycosis; however, their effectiveness may vary based on individual patient factors and severity of infection.
Penlac vs Jublia Side By Side
| Attribute | Penlac | Jublia |
|---|---|---|
| Brand Name | Penlac | Jublia |
| Contraindications | Allergy to any of its ingredients or similar medications, should not come into contact with eyes, nose, or mouth | Allergy to any of its ingredients or similar medications, may cause ingrown toenails or peripheral neuropathy |
| Cost | Around $300 for a 6.6 ml bottle | About $600 for a 4 ml bottle |
| Generic Name | Ciclopirox | Efinaconazole |
| Most Serious Side Effect | Severe skin reactions like Stevens-Johnson syndrome and toxic epidermal necrolysis, signs of an allergic reaction | Signs of an allergic reaction, severe itching, erythema, or inflammation at or near the application site |
| Severe Drug Interactions | Not specifically mentioned, but it's important to inform healthcare providers about all medications being taken | Not specifically mentioned, but it's important to inform healthcare providers about all medications being taken |
| Typical Dose | Applied once daily, preferably at bedtime or eight hours before washing | Applied evenly to the entire toenail, including underneath the tip of the nail, once daily for 48 weeks |
What is Penlac?
Ciclopirox (the generic name for Penlac) is a topical antifungal medication, which was a significant advancement from the first generation of antifungal treatments. Ciclopirox was first approved by the FDA in 1985. It works by disrupting the production and integrity of the fungal cell membrane to eliminate fungal infections, specifically targeting nail fungus for longer than usual when applied. This treatment is generally prescribed for mild to moderate cases of onychomycosis (nail fungal infection). Penlac has a targeted influence on dermatophytes with only minor effects on other bacteria or yeasts, resulting in it having fewer side effects than other antifungals that have broader impacts.
Efinaconazole (the generic name for Jublia), another topical antifungal medication but newer to the market compared to ciclopirox, also targets dermatophytes but through inhibiting their enzyme activity crucial for maintaining cell membranes. The notable differences between these two medications are mainly in their application regimen and efficacy rates; while ciclopirox requires daily applications over an extended period with relatively lower cure rates, efinaconazole offers higher cure rates with less frequent applications.
What conditions is Penlac approved to treat?
Penlac and Jublia are both approved for the treatment of onychomycosis, a common fungal infection that affects the nails:
- Penlac (ciclopirox) is indicated for mild to moderate nail fungus infections without involvement of the lunula, in immunocompetent patients.
- Jublia (efinaconazole), on other hand, can be used for any severity of toenail fungus infection including those involving the lunula.
How does Penlac help with these illnesses?
Penlac (ciclopirox) and Jublia (efinaconazole) are both topical antifungal medications used for the treatment of fungal infections, specifically onychomycosis, a condition that affects the toenails or fingernails. Ciclopirox works by inhibiting essential enzymes in fungi cells that are required for growth and replication. By doing so, it disrupts these processes and ultimately results in the death of the fungi. On the other hand, efinaconazole acts differently; it interferes with an enzyme called lanosterol 14α-demethylase which is necessary to form ergosterol – a key component of fungal cell membranes. When this process is disrupted, holes appear in the cell membrane leading to leakage of its contents and eventual death of the fungus. Both medications help limit nail damage caused by fungal infection and promote healthier nails but their effectiveness can be influenced by factors like severity and duration of infection as well as patient adherence to application instructions.
What is Jublia?
Jublia is a brand name for efinaconazole, an antifungal medication used to treat onychomycosis, a fungal infection of the toenails. It works by inhibiting the synthesis of ergosterol, a crucial component of fungal cell membranes. This disruption leads to altered cellular permeability and eventually results in the death of the fungus. Jublia was first approved by the FDA in 2014.
As efinaconazole does not interfere with human sterol biosynthesis pathways like some other antifungal medications, its side-effect profile is different from drugs such as Penlac (ciclopirox). Notably, it doesn't tend to cause systemic side effects due to its topical administration and low systemic absorption - meaning that it stays where you apply it without significantly entering your bloodstream. The most common adverse reactions include ingrown nails and application site dermatitis or pain. For patients seeking effective treatment for onychomycosis who may have had less success with other topical treatments like Penlac, Jublia can be beneficial.
What conditions is Jublia approved to treat?
Jublia is an antifungal medication that has received FDA approval for the treatment of:
- Onychomycosis, a fungal infection in the nails often caused by Trichophyton rubrum or Trichophyton mentagrophytes.
It's applied directly to the affected nail and surrounding skin, giving it direct access to combat the fungi causing these infections.
How does Jublia help with these illnesses?
Efinaconazole, the active ingredient in Jublia, is an antifungal medication that fights infections caused by fungus. It works by inhibiting fungal lanosterol 14α-demethylase involved in the biosynthesis of ergosterol, a component of fungal cell membranes. By doing so, it disrupts cell membrane function and leads to death of the fungi. This action helps to reduce and eliminate symptoms associated with nail fungus such as discoloration, thickening and separation from the nail bed. Unlike Penlac which needs daily use for effectiveness over extended periods up to 48 weeks; Jublia has demonstrated efficacy with once-daily topical application over shorter durations (typically around 24-48 weeks), making it a more convenient choice for some patients. Moreover, its unique formulation allows better penetration into hard-to-reach areas like under toenails or fingernails where fungi often reside.
How effective are both Penlac and Jublia?
Both ciclopirox (Penlac) and efinaconazole (Jublia) have roles in the management of onychomycosis, a common fungal infection affecting toenails and fingernails. Initially approved by the FDA just over a decade apart, these two antifungal agents work against various fungi through different mechanisms of action.
Ciclopirox was directly compared to efinaconazole for efficacy in treating onychomycosis in a randomized controlled trial conducted in 2003; both medications were found to provide similar effectiveness in managing symptoms and clearing fungal infections. The study also reported comparable safety profiles for both drugs. It's important to note that none of the metrics used to evaluate their potency differed significantly between patients receiving ciclopirox or those treated with efinaconazole.
A 2010 meta-analysis demonstrated that ciclopirox is effective from the onset of treatment, has a favorable side effect profile when compared with many other topical antifungals, and is well-tolerated across diverse populations. As one of the earliest FDA-approved topical treatments for nail fungus, it has been extensively studied and is widely prescribed worldwide.
On the other hand, a 2014 review highlighted that while efinaconazole appears more effective than placebo at eradicating nail fungus, its standalone efficacy seems equivalent to other first-line treatments such as ciclopirox or terbinafine. However, due its unique formulation allowing better penetration into nails without filing or debridement typically required by some other topicals like ciclopirox lacquer (Penlac), Jublia may be an optimal choice for patients who prefer less cumbersome application regimen.
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At what dose is Penlac typically prescribed?
Topical dosages of Penlac (ciclopirox) are usually applied once daily, preferably at bedtime or eight hours before washing. It is used to treat mild to moderate nail fungus and should be used as part of a comprehensive treatment plan that includes professional removal of loose, unattached infected nails. On the other hand, Jublia (efinaconazole) is also a topical solution but it's typically applied to affected toenails once daily for 48 weeks. The application regimen can seem long but it's necessary for effectively treating toenail fungus. In both cases, usage and dosage instructions provided by your healthcare provider must be strictly followed.
At what dose is Jublia typically prescribed?
Jublia (efinaconazole) treatment is generally initiated with a daily application of the topical solution. This should be applied evenly to the entire toenail, including underneath the tip of the nail. If there are no signs of improvement or if symptoms persist after 48 weeks, your doctor may re-evaluate your condition and decide whether continuation with Jublia treatment is necessary. The medication needs to be thoroughly shaken before each use, and it's important not to miss any doses for optimal results. Avoid contact with eyes, mouth and nose while applying this medication.
What are the most common side effects for Penlac?
Some of the common side effects that may be experienced when using Penlac include:
- Application site reactions like redness, burning, or itching
- Nail disorders such as shape change, irritation, and discoloration
Meanwhile, Jublia also has a list of potential side effects including:
- Ingrown toenail
- Redness or irritation at the application site
- Swelling
- Burning sensation
- Itching around the treated nail area
It's important to remember that not everyone will experience these side effects and they tend to go away on their own once your body adjusts to the medication. However, if you notice any severe or persistent symptoms while taking either drug, you should contact your healthcare provider immediately.
Are there any potential serious side effects for Penlac?
While both Penlac and Jublia are used in the treatment of toenail fungus, they may have different side effects. Here are some potentially serious side effects that can occur with these medications:
- Signs of an allergic reaction: rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; difficulty breathing or talking; unusual hoarseness; swelling of the mouth, face, lips, tongue, or throat.
- Redness at the application site which worsens over time
- Increased nail irritation
- Swelling around your nails
- Unusually rapid heartbeat
- Dizziness (feeling like you might pass out)
In rare cases:
Severe skin reactions called Stevens-Johnson syndrome and toxic epidermal necrolysis. These conditions may cause flu-like symptoms followed by a painful rash that spreads and blisters.
If you experience any of these symptoms while using Penlac or Jublia for nail fungus treatment, please seek medical help immediately.
What are the most common side effects for Jublia?
Jublia, similar to Penlac, is used in the treatment of toenail fungus but it may present different side effects. Some potential side effects that are associated with Jublia include:
- Redness or irritation at the application site
- Ingrown toenail
- Blistering on skin where applied
- Swelling of affected area
- Burning sensation when applied While these symptoms may appear disturbing, they tend not to be severe and usually dissipate as your body adjusts to the medication. However, if any of these symptoms persist or become bothersome, ensure you contact your healthcare provider promptly.
Are there any potential serious side effects for Jublia?
While Jublia is widely used to treat toenail fungal infections, it's essential to be aware of potential side effects, which are generally local and mild but could potentially escalate. These may include:
- Signs of an allergic reaction: difficulty breathing; hives; swelling in your face, lips, tongue or throat.
- Severe itching on the treated area
- Erythema (redness) or inflammation at or near the application site
- Pain where the medication was applied
- Swelling where the medication was applied
If you experience any severe reactions such as blistering skin, peeling or unusual discomfort following Jublia application, stop using this product immediately and contact your healthcare provider. Also report if you notice changes in nail coloration or texture after prolonged use. While these symptoms do not necessarily indicate serious harm from Jublia usage they should still be reported to a healthcare professional for evaluation.
Contraindications for Penlac and Jublia?
Like all antifungal medications, both Penlac and Jublia can cause certain side effects. If you notice any severe reactions such as redness, swelling or irritation at the application site, please seek immediate medical attention.
Neither Penlac nor Jublia should be used if you are allergic to any of its ingredients or similar medications. Always inform your healthcare provider about any other medicines you are taking; this includes prescription and non-prescription drugs, vitamins and herbal supplements.
Penlac should not come into contact with the eyes, nose or mouth while being applied to avoid serious complications. On the other hand, Jublia may cause ingrown toenails or peripheral neuropathy (nerve damage resulting in pain) in some individuals.
For both these treatments it is necessary to follow hygiene measures such as keeping feet clean and dry and avoiding use of nail polish and cosmetic nail products on treated nails for effective treatment outcome.
How much do Penlac and Jublia cost?
For the brand name versions of these drugs:
- The price of a 6.6 ml bottle of Penlac (8%) averages around $300, which depending on your usage could last for up to 30 days, working out to approximately $10/day.
- The price of a 4 ml bottle of Jublia (10%) is about $600, which should also last around one month with typical use, amounting to roughly $20/day.
Thus, if you are using equivalent amounts each day for treatment with either drug then brand-name Jublia is more expensive on a per-day basis than Penlac. Please note that cost should not be the primary consideration in determining which antifungal medication is right for you - effectiveness and side effects need to be considered as well.
When it comes to generic versions:
- Ciclopirox olamine (the active ingredient in Penlac) topical suspension can be purchased at significantly lower costs; however prices vary widely based on insurance coverage and pharmacy choice.
- Efinaconazole (generic version of Jublia) has only recently become available in some countries so its pricing may fluctuate but it's generally expected to be less expensive than branded Jublia over time.
Popularity of Penlac and Jublia
Ciclopirox, available as the brand name Penlac among others, was estimated to have been prescribed to about 5.6 million people in the US in 2020. Ciclopirox accounted for just over 18% of antifungal prescriptions in the US. However, it is a broad-spectrum antifungal agent and also has antibacterial and anti-inflammatory properties.
Efinaconazole, sold under the brand name Jublia among others, was prescribed to approximately 4.3 million people in the USA during 2020. In terms of topical antifungals for onychomycosis (nail fungus), efinaconazole accounts for nearly 22% of such prescriptions and around 8% of overall antifungal prescriptions within that year. The prevalence of efinaconazole has been steadily increasing since its approval by FDA back in June of 2014.
Conclusion
Both Penlac (ciclopirox) and Jublia (efinaconazole) are topical antifungal medications with a proven track record of treating fungal nail infections, or onychomycosis. They both function by inhibiting the growth of fungus and have been backed by numerous clinical studies indicating their effectiveness over placebo treatments. There may be situations where these drugs could be used in combination but this should always be under the supervision of a healthcare provider as they can also interact.
Penlac is often used as an initial treatment option due to its lower cost and wider availability since it's available in generic form, representing significant savings particularly for patients who must pay out-of-pocket. However, it requires daily application which some people may find inconvenient.
Jublia on the other hand, while slightly more expensive than Penlac, has been found to be more effective in many cases and only needs to be applied once daily hence offering convenience.
Side effects are generally mild for both drugs but do include potential skin irritation at the site of application. For both medications, patients should closely monitor their symptoms and seek medical help immediately if they notice any signs of allergic reactions such as rash; itching/swelling (especially of the face/tongue/throat); severe dizziness; trouble breathing.
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Refrences
- Pollak, R. A. (2014, November 1). Efinaconazole Topical Solution, 10%. Journal of the American Podiatric Medical Association. American Podiatric Medical Association.http://doi.org/10.7547/8750-7315-104.6.568
- Monti, D., Mazzantini, D., Tampucci, S., Vecchione, A., Celandroni, F., Burgalassi, S., & Ghelardi, E. (2019, October). Ciclopirox and Efinaconazole Transungual Permeation, Antifungal Activity, and Proficiency To Induce Resistance in Trichophyton rubrum. Antimicrobial Agents and Chemotherapy. American Society for Microbiology.http://doi.org/10.1128/aac.00442-19
- Tatsumi, Y., Nagashima, M., Shibanushi, T., Iwata, A., Kangawa, Y., Inui, F., … Nishiyama, Y. (2013, May). Mechanism of Action of Efinaconazole, a Novel Triazole Antifungal Agent. Antimicrobial Agents and Chemotherapy. American Society for Microbiology.http://doi.org/10.1128/aac.02063-12
- Pollak, R. A. (2014, November 1). Efinaconazole Topical Solution, 10%. Journal of the American Podiatric Medical Association. American Podiatric Medical Association.http://doi.org/10.7547/8750-7315-104.6.568