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Ketoconazole

Ketoconazole is an antifungal medication used to treat certain serious fungal infections in the body. Some common side effects include nausea, headache, dizziness, and stomach upset ? your doctor will normally ensure the benefits outweigh these concerns.

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Frequently Asked Questions

Can I stop taking Ketoconazole once the symptoms disappear?
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It is important to complete the prescribed course of medicine even if your symptoms disappear. Stopping the medication too soon may allow the fungus to continue to grow and the infection might return.

Can I stop taking Ketoconazole without finishing the course?
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It is not advisable to stop this medication abruptly unless your doctor recommends it. Indeed, the fungal infection might come back if you stop the medication too soon.

Can I take Ketoconazole if I am breastfeeding?
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Yes, but it's always a good idea to discuss with your doctor first, as small amounts may pass into breast milk.

Does Ketoconazole have any interactions with grapefruit juice?
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Yes, grapefruit juice can increase the amount of Ketoconazole that your body absorbs. It is advisable to avoid consuming grapefruit while on this medication.

Does Ketoconazole interfere with other medications?
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Ketoconazole can interact with many different medications, including certain anticoagulants and cholesterol medications. Always inform your healthcare provider about all other medications you're taking.

I missed a dose of Ketoconazole. What should I do?
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Take the missed dose as soon as you remember, unless it's almost time for your next dose. Do not take two doses to make up for the missed one.

Is it safe to drink alcohol while on Ketoconazole?
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Alcohol should be consumed in moderation while taking Ketoconazole, as it may increase the chance of liver damage.

Is Ketoconazole safe during pregnancy?
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Ketoconazole should be used during pregnancy only if the potential benefits justify the potential risks. Always consult your healthcare provider.

What should I do if I miss a dose?
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If it is close to the time for your next dose, skip the missed dose and go back to your normal time. If it is still early, consume the missed dose as soon as possible.

Comprehensive Drug Guide

How Does Ketoconazole Work?

Ketoconazole functions by inhibiting fungal cytochrome P450 synthesizing enzymes. This prevents ergosterol (a major component) formation that affects fungal cell membrane stability and replication.

What is Ketoconazole Used For?

FDA indications: Ketoconazole is used primarily to treat severe fungal infections such as candidiasis, coccidioidomycosis, histoplasmosis, chromomycosis, and paracoccidioidomycosis, not responsive to other treatments.

Offlabel uses: Ketoconazole can also be used to treat high cortisol levels in the body (Cushing's syndrome), and some types of prostate cancer.

Common Dosages

Tablets: 200mg

Topical Cream: 2%

Shampoo: 1% for overthecounter, 2% requires prescription

Typical Dosing

FDA Approved Indications

  • Serious fungal infections: 200 to 400mg once a day.

Off-Label Uses

  • Cushing's syndrome: 400 to 1200mg per day in divided doses.
  • Prostate cancer: Usually, 400mg once daily.

Who Shouldn't Take Ketoconazole?

  • People with a known allergy to Ketoconazole.
  • If you have liver disease or adrenal gland issues.
  • If you consume alcohol regularly.
  • If you also use methotrexate (used for cancer, psoriasis, or rheumatoid arthritis).
  • Are pregnant, planning to become pregnant, or breastfeeding (Its effects during pregnancy or breastfeeding are not fully known).

Advice From The Pharmacist

  • Intake of antacids, antidiarrheals, or any stomach acid reducers should be spaced 2 hours apart from your Ketoconazole dosage.
  • Ketoconazole can be taken with a nondiet cola drink if you have a reduced stomach acid condition.
  • Liver Function tests should be checked before starting treatment.
  • The use of alcohol should be avoided.
  • If symptoms of hepatitis emerge, such as loss of appetite, fatigue, jaundice, dark urine, lightcolored feces, or pain in the upper right quadrant, medical aid should be sought promptly.
  • In case of unusual rapid weight gain or swelling, irregular heart rate, dizziness, lightheadedness, or fainting, a doctor should be consulted immediately.

Side Effects of Ketoconazole

Common Side Effects

  • Common side effects:
  • Nausea or vomiting.
  • Mild itching or skin rash.
  • Unusual tiredness.
  • Headaches.

Uncommon/Severe Side Effects

  • Swelling, rapid weight gain.
  • Little or no urination.
  • Lightheadedness.
  • Erectile dysfunction in men, painful or difficult erection lasting 4 hours or longer.
  • Easy bruising, unusual bleeding.
  • Chest pain, irregular heartbeats.
  • Signs of an allergic reaction like hives, difficulty breathing, swelling in your face or throat.

Risks and Warnings of Ketoconazole

  • Individuals with liver issues should consult their physician before the administration of Ketoconazole, as it can stress the liver.
  • If you're on methotrexate or similar drugs, the concomitant use of Ketoconazole may lead to possible drug interaction; hence, caution should be exercised.
  • Pregnant women and nursing mothers should exercise caution.
  • Liver function tests might be prescribed by your healthcare provider to check for liver damage.
  • Make sure to inform your healthcare provider about any underlying health conditions before starting Ketoconazole.

Interactions with Ketoconazole

Common Drug Interactions

  • Certain statins like atorvastatin, lovastatin, and simvastatin.
  • Alfentanil, fentanyl, sufentanil.
  • Triazolam, midazolam
  • Certain antiretroviral drugs.
  • Cisapride
  • Colchicine

Alternatives to Ketoconazole

  • Fluconazole
  • Voriconazole
  • Posaconazole
  • Isavuconazonium
  • Itraconazole