AMOROLFINE EG 5 % medicated nail lacquer bottle/2,5ml+10 spatula

Medicated nail lacquer.

Amorolfine hydrochloride.............................................................................................................................. 5,57 g

Quantity corresponding to amorolfine base................................................................................................. 5,00 g

For 100 ml.

Excipients:

First-line treatment of onychomycosis without matrix involvement.

Dosage

Apply AMOROLFINE EG to the affected nails at a dosage of once or twice a week.

Method of administration

To apply the lacquer, carefully follow the recommendations below:

For packs without accessories:

a) Before the first application of AMOROLFINE EG, carefully clean the nails, file the affected area of the nail (in particular the nail surface) using a nail file, as completely as possible.

Take care not to file the periungual skin.

b) Clean the nail surface and degrease it using a compress or a cloth soaked in solvent.

c) Apply the lacquer using one of the reusable spatulas over the entire affected nail. Clean the reusable spatula between each nail to avoid contaminating the lacquer. Do not wipe the spatula on the rim of the bottle.

d) It is important to thoroughly clean the spatula using one of the cleansing wipes provided after each application, before reusing it on another nail, to avoid contaminating the varnish.

e) If varnish has been deposited on the outside of the cap during handling, it is important to clean it using one of the cleansing wipes provided, to avoid applying this varnish to the skin.

f) Reseal the bottle tightly.

Repeat all of the above steps for each affected nail.

Treatment must be continued without interruption until complete regeneration of the nail and clinical and mycological cure of the affected areas.

The duration of treatment is generally 6 months for fingernails and 9 months for toenails (it depends essentially on the severity and location of the infection and the extent of nail involvement).

Special instructions:

• Do not reuse nail files on healthy nails.

• Before each new application, file the affected nails if necessary and in all cases clean them using nail polish remover to remove residual lacquer.

• When handling organic solvents (white spirit, thinners…), it is necessary to wear waterproof gloves in order to protect the AMOROLFINE EG lacquer layer on the nails.

For packs with accessories:

a) Before the first application of AMOROLFINE EG, carefully clean the nails, file the affected area of the nail (in particular the nail surface) using a nail file, as completely as possible.

Take care not to file the periungual skin.

b) Clean the nail surface and degrease it using one of the cleansing wipes provided, to remove any trace of residual varnish.

c) Apply the lacquer using one of the reusable spatulas over the entire affected nail. Clean the reusable spatula between each nail to avoid contaminating the lacquer. Do not wipe the spatula on the rim of the bottle.

d) It is important to thoroughly clean the spatula using one of the cleansing wipes provided after each application, before reusing it on another nail, to avoid contaminating the varnish.

e) If varnish has been deposited on the outside of the cap during handling, it is important to clean it using one of the cleansing wipes provided, to avoid applying this varnish to the skin.

f) Reseal the bottle tightly.

Repeat all of the above steps for each affected nail.

Treatment must be continued without interruption until complete regeneration of the nail and clinical and mycological cure of the affected areas.

The duration of treatment is generally 6 months for fingernails and 9 months for toenails (it depends essentially on the severity and location of the infection and the extent of nail involvement).

Special instructions:

Do not reuse nail files on healthy nails.

Before each new application, file the affected nails if necessary and in all cases clean them with the cleansing wipes to remove residual varnish.

When handling organic solvents (white spirit, thinners…), it is necessary to wear impermeable gloves in order to protect the AMOROLFINE EG nail lacquer layer on the nails.

Hypersensitivity to the active substance or to any of the excipients listed in section Composition.

Special warnings

Avoid any contact of AMOROLFINE EG with the eyes, ears or mucous membranes.

AMOROLFINE EG must be used with caution in patients with conditions predisposing to nail disorders (peripheral circulatory disorders, diabetes, immune system diseases) as well as in patients presenting with nail dystrophy or severely damaged nails (more than two thirds of the nail plate is affected). In these cases a systemic treatment should be considered.

Do not use cosmetic nail polish or artificial nails while using AMOROLFINE EG.

If organic solvents are handled, waterproof gloves must be worn, otherwise the varnish will be dissolved.

A systemic or local allergic reaction could possibly occur after use of this medicine. If this occurs, the medicine must be stopped immediately and a doctor must be consulted. Carefully remove the product using nail polish remover. The medicine must not be reused.

Precautions for use

In the absence of data, the use of AMOROLFINE EG is not recommended in patients under 18 years of age.

The data available to date do not suggest the existence of clinically significant interactions.

There are limited data on the use of amorolfine in pregnant and breastfeeding women. Only a small number of pregnancies exposed to topical amorolfine have been reported after marketing, so the potential risk is unknown.

Studies performed in animals have shown reproductive toxicity at high oral doses (see section Preclinical safety).

It is not known whether amorolfine is excreted in human milk.

AMOROLFINE EG must not be used during pregnancy and breastfeeding, except in cases of real necessity.

System Organ Class	Frequency	Adverse effects
Immune system disorders	Frequency not known (cannot be estimated from the available data)	Hypersensitivity (systemic allergic reaction)*
Skin and subcutaneous tissue disorders	Rare (≥ 1/10 000, < 1/1 000)	Nail disorder, nail discolouration, brittle nails (onychoclasis), fragile nails (onychorrhexis)
	Very rare (< 1/10 000)	Sensation of skin burning
	Frequency not known (cannot be estimated from the available data)	Erythema, pruritus, contact dermatitis, urticaria, blister

* Adverse effects reported since marketing.

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reaction via the national reporting system: National Agency for the Safety of Medicines and Health Products (ANSM) and the network of Regional Centres of Pharmacovigilance - Website: www.ansm.sante.fr.

No systemic signs of overdose are expected after topical application of AMOROLFINE EG.

In case of accidental ingestion, appropriate symptomatic measures should be taken.

Pharmacotherapeutic class: Other antifungals for topical use, ATC code: D01AE16.

AMOROLFINE EG is a topical antimycotic. The active ingredient, amorolfine, derived from morpholine, belongs to a new chemical class of antimycotics.

Its fungistatic and fungicidal effect is based on an alteration of the fungal cell membrane mainly targeting sterol biosynthesis.

The ergosterol content is reduced. An accumulation of atypical sterols leads to morphological changes in cell membranes and organelles that cause the death of the fungal cell.

Amorolfine has a broad antimycotic spectrum. It is very effective against the usual or occasional agents of onychomycosis:

• Yeasts:

• Candida albicans and other Candida species.

• Dermatophytes:

• Trichophyton rubrum, Trichophyton interdigitale and Trichophyton mentagrophytes, other species of Trichophyton,
• Epidermophyton floccosum,
• Microsporum.

• Moulds:

• Scopulariopsis.

• The dematiaceous (black fungi):

• Hendersonula, Alternaria, Cladosporium.

• Species with low sensitivity:

• Aspergillus, Fusarium, mucorales.

Amorolfine in the form of a nail lacquer penetrates and diffuses through the nail plate and is able to eradicate fungi that are poorly accessible in the nail bed.

The general absorption of the active ingredient is negligible, with the plasma concentration remaining below the sensitivity threshold, even after one year of use.

In rats, amorolfine is not teratogenic and is not embryotoxic at the maximum oral dose tested of 40 and 80 mg/kg/day. However, signs of maternal toxicity (weight loss) were observed at doses of 40 and 80 mg/kg/day.

In rabbits, amorolfine is not teratogenic but has an embryotoxic effect at the maximum oral dose tested of 10 mg/kg/day. Maternal weight loss, reflecting maternal toxicity, was also observed at the dose of 10 mg/kg/day.

Due to the very low systemic absorption of amorolfine following application to the nail or skin, the potential risk of toxicity to the human fetus is negligible.

3 years.

No special precautions for storage.

No special requirements.

Marketing authorisation (AMM)

CIP 3400930007303 (Fl/2,5ml+10 spat).

Price:

9,32 euros (Fl/2,5ml+10 spat).

Social Security reimbursement at 30% under the indications:

• Indication(s) appearing in the marketing authorisation at the date of publication of this decree

Collection.