Meds and you

Updated 11 February 2013

Ketoconazole

Ketoconazole is an antibiotic medication used in treating infections of the vagina, skin, hair and nails.

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Ketoconazole is the active ingredient of Adco-Dermed, Ketazol, Kez, Nizcreme, Nizoral, Nizshampoo and Sandoz Ketoconazole.

General information

Ketoconazole is an antibiotic medication used in treating infections of the vagina, skin, hair and nails caused by sensitive fungal and yeast infections that do not respond to conventional topical treatment. It is also prescribed for severe systemic infections.

It is only effective in treating fungal infections and will not be effective in treating bacterial or viral infections.

Gastrointestinal upset is one of the most common side effects observed with this medication, but can be overcome by taking ketoconazole with meals.

Ketoconazole is best absorbed at highly acidic levels, so antacids or other causes of decreased stomach acid levels will lower the drug's absorption when taken orally.

Besides the oral form, Ketoconazole is also available as a cream to treat fungal skin infections, and as a shampoo to treat scalp conditions such as seborrhoea dermatitis.

How does it work?

Ketoconazole inhibits the manufacturing of substances vital for fungal growth and functioning.

Fast facts

Drug schedule: Schedule 1, 4

Available as: Tablets, liquids, cream and shampoo

What does it do? Ketoconazole has an antifungal action

Overdose risk: Medium

Dependence risk: Low

Available as a generic ? Yes

Available on prescription only? Yes (oral form)

User information

Onset of effect: May take several days to reach full effect.

Duration of action: Up to 24 hours.

Dietary advice: Ketoconazole should be taken with meals.

Stopping: Complete the full course as directed by your doctor; even if you feel better, symptoms may recur with premature discontinuation.

Prolonged use: The risk of liver damage increases with prolonged use; periodic liver function tests may be needed.

Special precautions

Consult your doctor before using this drug:

  • If you have a liver disease
  • If you are allergic to any other anti-fungal medication
  • If you are taking any other medication

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: A reduced dose is advised in infants and children.

Elderly: No special precautions need be taken.

Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness. Avoid such activities until you know how it affects you.

Alcohol: Avoid concomitant use.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Nausea/vomiting

x

x

Abdominal pain

x

x

Diarrhoea

x

x

Skin rash

x

x

Fever/ chills

x

x

Headache

x

x

Dizziness

x

x

Sun sensitivity

x

x

Menstrual irregularities

x

x

Jaundice

x

x

Dark urine

x

x

Pale stool

x

x

Interactions

Drug interactions

Benzodiazepines

Increased risk of benzodiazepine toxicity

Ciclosporin

Increase risk of cyclosporin toxicity

Cisapride

Risk of heart rhythm disturbance

Corticosteroids

Risk of corticosteroid toxicity

Oral contraceptives

Possible reduced efficacy of contraceptives. Adrenal suppression enhanced

Rifampicin

Reduced effect of ketoconazole

Sulphonylurea drugs such as Tolbutamide, Glibenclamide and Glipizide

Risk of severely low blood sugar levels

Tacrolimus

Risk of kidney toxicity

Terfenadine

Risk of heart rhythm disturbance

Theophylline

Possible toxic levels of theophylline

Warfarin

Risk of warfarin toxicity

Zidovudine

Risk of zidovudine toxicity

Alcohol

Disulfiram reaction

Drugs for epilepsy

May decrease ketoconazole levels

Digoxin

Risk of digoxin toxicity

Antacids, cimetidine, ranitidine, sucralfate

Decreased effect of ketoconazole

Isoniazid

Decreased effect of ketoconazole

Disease interactions

Consult your doctor before using this drug if you have a liver disease, or if you are allergic to any other anti-fungal medication.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage

Adults: 200-400 mg twice daily (oral form)

Interesting fact

Ketoconazole as a shampoo has shown to be beneficial in men suffering from androgenic alopecia, or hair loss.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 

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