Topical antifungal (morpholine) Pregnancy: Avoid — limited data. Defer treatment until after pregnancy unless severe.

Amorolfine

Brand names: Loceryl, Curanail

Adult dose

Dose: Nail lacquer 5%: apply once or twice weekly to affected nail. Continue 6 months for fingernails, 9–12 months for toenails. Cream 0.25%: apply once daily at bedtime for 3–6 weeks.

Route: Topical

Frequency: Weekly (lacquer) or daily (cream)

File affected nail down before lacquer application; clean with alcohol pad. Allow to dry 3–5 minutes.

Clinical pearls

First-line for mild distal subungual onychomycosis affecting <2 nails or <50% nail surface (BAD Guideline).
For severe disease (matrix involvement, ≥3 nails, immunocompromised), oral terbinafine is more effective — combine with topical amorolfine for adjunctive benefit.
Treatment is long (9–12 months for toenails); counsel about adherence and slow visible response — wait for healthy nail growth.
Curanail 5% available OTC in UK pharmacy.
Confirm diagnosis with nail clipping for mycology before starting — many dystrophic nails are not fungal.

Contraindications

Children under 12 years
Hypersensitivity to amorolfine

Side effects

Nail discolouration, brittleness
Burning, redness, pruritus around nail
Onycholysis (rare)
Allergic contact dermatitis (rare)

Interactions

Other topical nail products: avoid simultaneous use

Monitoring

Treatment response at 3 months and 6 months

Reference: BNF 90; SmPC Loceryl / Curanail; BAD Onychomycosis Guideline 2014; NICE CKS Fungal Nail Infections. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Pathways