Clioquinol
| Evidence Level: L4 | Predicted Indications: 7 |
Table of Contents
Clioquinol: From Tinea Infections to Cutaneous Candidiasis
One-Sentence Summary
Clioquinol is a topical halogenated hydroxyquinoline, originally used for dermatophyte skin infections such as tinea pedis and tinea corporis. The TxGNN model predicts it may be effective for cutaneous candidiasis, but there are currently no registered clinical trials and only 1 indirect publication supporting this direction, so the evidence is very limited.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Tinea pedis, tinea corporis, tinea infection, dermatophytosis of groin and perianal area |
| Predicted New Indication | Cutaneous candidiasis |
| TxGNN Prediction Score | 99.84% |
| Evidence Level | L4 |
| UK Market Status | Marketed |
| Number of Marketing Authorisations | 5 |
| Recommended Decision | Hold |
Note: the original indications come from the TxGNN knowledge graph. The authorisation records compiled for this report contain no approved indication text.
Why is This Prediction Reasonable?
Detailed mechanism of action data is not currently available. Based on general knowledge of the drug class, clioquinol has topical antifungal and antibacterial activity. It is thought to act by chelating metal ions (copper, zinc, iron) and disrupting fungal cell function. This is not confirmed by the data compiled for this report.
Its use in dermatophyte infections (tinea) is established. Because metal chelation is not specific to one fungal group, the activity could plausibly extend from dermatophytes to Candida species, which cause cutaneous candidiasis.
The score of 99.84% is a computational prediction only. The single retrieved publication is a 1988 in vitro study on preventing occupational Candida albicans infection. It is indirect and is not a controlled efficacy study of clioquinol.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 2978600 | 1988 | Other (in vitro/prevention report, inferred from title) | Przeglad dermatologiczny | In vitro study of additives to toilet soaps and their effects on C. albicans strains from patients. Indirect evidence, not a clioquinol efficacy study. |
Related evidence for another predicted indication (superficial mycosis):
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 33772895 | 2021 | Preclinical/in vitro (inferred from title) | Mycoses | Evaluated clioquinol combined with ciclopirox and terbinafine for antidermatophytic activity and irritant potential in alternative models of dermatophytosis. |
UK Market Information
| Marketing Authorisation Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 1201010F0BBAAAA | Locorten-Vioform Ear Drops | Ear drops | Not available |
| 1304000N0AACACA | Fluocinolone/Clioquinol Cream 0.025%/3% | Cream | Not available |
| 1201010F0AAAAAA | Flumetasone/Clioquinol Ear Drops 0.02%/1% | Ear drops | Not available |
| 1304000V0AACLCL | Clioquinol/Hydrocortisone Ointment 3%/1% | Ointment | Not available |
| 1304000F0AACACA | Betamethasone Valerate/Clioquinol Cream 0.1%/3% | Cream | Not available |
All five are valid single-ingredient records. The identifiers above are as held in the compiled data and are not in standard MHRA PL number format. Dosage forms are taken from the product names.
Safety Considerations
- Knowledge-graph contraindication signals (from drug-disease relationships, not label text): adrenocortical insufficiency, Addison disease, skin atrophy, telangiectasis, capillary disease, hereditary haemorrhagic telangiectasia, peripheral vascular disease, intermittent claudication, and peripheral arterial disease. Several of these are likely to reflect the corticosteroid components of the combination products rather than clioquinol itself.
- Drug interactions: no interaction data were found.
Please refer to the SmPC and BNF for full safety information. Report suspected adverse reactions via the Yellow Card Scheme.
Other Predicted Indications (for context)
| Predicted Indication | TxGNN Score | Evidence Level | Comment |
|---|---|---|---|
| Superficial mycosis | 99.18% | L4 | Closest to the existing indications. Only indirect preclinical support. |
| Majocchi granuloma | 99.26% | L5 | Deep follicular infection. Topical penetration is poor. |
| Ectothrix infectious disease | 99.26% | L5 | Hair-shaft infection. Systemic therapy is usually needed. |
| Endothrix infectious disease | 99.19% | L5 | Intrahair infection. Systemic therapy is standard. |
| Dermatophytosis of scalp or beard | 99.17% | L5 | Topical monotherapy is generally inadequate. Absorption and neurotoxicity concerns. |
| Tinea profunda | 99.13% | L5 | Deep dermal infection. Topical therapy is unlikely to suffice. |
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction for cutaneous candidiasis rests on a computational score and one indirect 1988 in vitro publication, with no clinical trials. Safety and mechanism data are also incomplete, so the evidence does not yet justify moving forward.
To proceed, the following is needed:
- Mechanism of action data (for example, from DrugBank)
- Approved indication text and SmPC safety information for the UK products
- In vitro susceptibility data for clioquinol against Candida species, followed by controlled clinical studies in cutaneous candidiasis
- A comparison against established topical antifungals (such as azoles) to show a benefit
- Review of systemic absorption and neurotoxicity concerns, particularly for use on large or inflamed skin areas
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.