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ketoconazole - oral, Nizoral (cont.)

PRECAUTIONS: Before taking ketoconazole, tell your doctor or pharmacist if you are allergic to it; or to other azole antifungal drugs (such as fluconazole, itraconazole); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver problems, alcohol use, low testosterone levels, decreased adrenal gland function problems (such as low cortisol levels, Addison's disease, adrenal insufficiency), little or no stomach acid production (achlorhydria).Do not drink alcohol while taking this medication because alcohol increases the risk of serious liver problems. Avoiding alcohol will also decrease the risk of a rare reaction with ketoconazole that may result in flushing, headache, and nausea.During pregnancy, this medication should be used only when clearly needed. It may cause harm to an unborn baby if taken during the first 3 months of pregnancy. Discuss the risks and benefits with your doctor.This medication passes into breast milk. However, this drug is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: See also Warning and How to Use sections.The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.Ketoconazole can interact with many other medications and products. Some products that may interact with this drug include: lanthanum, warfarin.Other medications can affect the removal of ketoconazole from your body, which may affect how ketoconazole works. Examples include efavirenz, isoniazid, nevirapine, rifamycins (such as rifabutin, rifampin), St. John's wort, among others.This medication can slow down the removal of many other medications from your body, which may affect how they work. Examples of affected drugs include some benzodiazepines (such as alprazolam, triazolam), cyclosporine, digoxin, domperidone, eletriptan, eplerenone, ergot drugs (such as ergotamine), drugs used to treat erectile dysfunction (such as sildenafil, tadalafil, vardenafil), HIV protease inhibitors (such as ritonavir), some drugs used to treat seizures (such as carbamazepine, phenytoin), some statin drugs (such as atorvastatin, lovastatin, simvastatin), tacrolimus, among others.Ketoconazole requires acid in the stomach to be well absorbed. Therefore, if you are taking drugs that decrease the amount of stomach acid including antacids, heartburn/ulcer drugs (H2 blockers such as cimetidine, famotidine, ranitidine), sucralfate, or if you are taking drugs that slow down gut movement (anticholinergics such as dicyclomine, propantheline), take ketoconazole at least 2 hours before any of these drugs. If you are taking proton pump inhibitors (PPIs such as lansoprazole, omeprazole), ask your doctor or pharmacist for advice on how to reduce or avoid this interaction.This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.



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