Medications and Drugs
Medical Author: Omudhome Ogbru, Pharm.D.
Medical Editor: Jay Marks, M.D.
GENERIC NAME: ketoconazole
BRAND NAME: Nizoral, Extina, Xolegel, Kuric
DRUG CLASS AND MECHANISM: Ketoconazole is an anti-fungal medication in
the same family of drugs as fluconazole (Diflucan), itraconazole (Sporanox), and miconazole (Micatin, Monistat). It prevents growth
of several types of fungi by preventing production of the membranes that
surround fungal cells. The FDA approved ketoconazole in June 1981.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 200 mg; Shampoo: 1 and 2%; Cream: 2%, Gel: 2%,
Foam: 2%
STORAGE: Tablets should be stored at room temperature, 15-25 C (59-77
F) and protected from moisture.
- Store shampoo 1% between 2-30 C (35-86 F) and
protect it from light and freezing.
- Store shampoo 2% at or below 25 C (77 F) and protect it from light.
- Store cream and foam at room temperature, 20-25 C (68-77 F).
- Store gel between 15-30 C (59- 86 F).
PRESCRIBED FOR: Oral ketoconazole treats a variety of fungal
infections such as candidiasis of the skin or mouth (thrush),
blastomycosis,
histoplasmosis,
coccidiomycosis, and others. Ketoconazole is also used to treat
fungal infections that have not responded to griseofulvin, another antifungal
medication. Topical ketoconazole is used for treating ringworm,
jock itch,
athlete's foot,
dandruff, and tinea versicolor.
DOSING: Ketoconazole may be taken with or without food. The oral dose
range is 200-400 mg daily. Topical formulations are administered to affected
areas once or twice daily.
DRUG INTERACTIONS: There are no known drug interactions with topical
ketoconazole.
Ketoconazole tablets require stomach acidity to dissolve. Therefore,
ketoconazole should be administered at least two hours before taking antacids or
other acid reducing medications such as
cimetidine (Tagamet) or
ranitidine (Zantac). Combining
ketoconazole with alcohol may cause a very unpleasant reaction (disulfiram
reaction).
Rifampin (Rifadin,
Rimactane,
Rifamate,
Rifater) reduces the blood concentration of oral ketoconazole, probably by
increasing the elimination of fluconazole by the liver. This may reduce the
effectiveness of ketoconazole.
Ketoconazole may increase the concentration of
warfarin (Coumadin) in blood by reducing the elimination of warfarin. Therefore, the effect
of warfarin may increase, leading to an increased tendency to bleed.
Ketoconazole also increases the concentration of phenytoin,
(Dilantin) cyclosporine,
zidovudine (Retrovir), theophylline
(Theo-Dur, Respbid, Slo-Bid, Theo-24, Theolair, Uniphyl, Slo-Phyllin), tolbutamide, glyburide
(Micronase, Diabeta, Glynase), glipizide
(Glucotrol), protease inhibitors [for example,
indinavir
(Crixivan), ritonavir
(Norvir), saquinavir (Invirase, Fortovase)],
midazolam (Versed) and triazolam
(Halcion).
Increased drug concentrations usually increase the incidence of side effects.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
- Ringworm - Ringworm (tinea) is caused by a fungal infection on the skin. Learn about symptoms, signs, diagnosis and treatment information. Pets can transmit the condition to humans.
- fluconazole, Diflucan - Clarifies the medication fluconazole (Diflucan), a drug used to treat oral, esophageal, urinary, vaginal and possibly other organ infections caused by the fungus Candida.
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