Other Brands/Names

A-Be, Anfuhex, Cidaral, Dandrufin, Dericazole, Dexazol, Dezor, Dysfungal, Erazol, Etafungal, Fexazol, Formyco, Fungasol, Fungoral, Grazol, Kanazol, Ketomed, Zumarol, Zoralin, Wizol, Tokasid, Thicazol, Sporex, Solinfec, Pronazol, Profungal, Picamic, Omegzol, Nofung, Mycoral, Mycoderm, Muchoral, Murazid, Lusanoc, Lamycos, Ketomed

How It Works

Ketoconazole is an antifungal medication that targets and disrupts the defenses of fungal cells. It does so by inhibiting the production of ergosterol, an essential component of fungal cell membranes. By interfering with the membrane formation, the medication prevents the growth of the fungus and ultimately leads to the death of the fungal cells responsible for the infection.

Indications

Ketoconazole is used to treat various fungal infections, including skin conditions like tinea versicolor or ringworm. It is also effective for treating systemic fungal infections in the body, such as candidiasis caused by Candida fungi or histoplasmosis caused by Histoplasma fungi.

Contraindications

Ketoconazole should not be used by individuals who have:

• A history of allergic reactions to ketoconazole (e.g., hives or swollen eyelids)

• Impaired liver function

• Pregnant women with Cushing’s syndrome or breastfeeding women

• Ketoconazole should not be used alongside terfenadine or astemizole.

Side Effects

Though side effects are uncommon, some may occur, including:

• Local burning sensation

• Hives

• Blisters

• Itching

• Skin peeling

• Redness

• Swelling or pain at the site of application

• Nausea and vomiting

• Abdominal pain

• Headache

• Liver damage

• Hair loss (baldness)

• Dizziness

Types

Ketoconazole is available in the following forms:

• Cream

• Shampoo

• Gel

• Lotion

• 200 mg Tablets (prescription required)

Dosage

Systemic fungal infections (oral medications)

• Adult dosage: 200 mg once daily, which may be increased to 400 mg once daily if there is no improvement. Continue until the infection is gone.
• Child dosage: For children over 2 years, the dose is 3.3–6.6 mg/kg body weight once daily until the infection resolves.

Skin fungal infections

Adult dosage:

• Cream: Apply to the affected area 1-2 times daily for 2-6 weeks, continuing for several days after symptoms resolve.

• Shampoo: Apply to a wet scalp once daily for up to 5 days.

Safety

Pregnancy:

Ketoconazole is classified as FDA Category C (animal studies have shown adverse effects on the fetus, but there are no adequate, well-controlled studies in humans). Therefore, the potential benefits and risks should be carefully evaluated, and the drug should be used with caution during pregnancy.

Drug Interactions

Cholesterol medications (e.g., simvastatin)

Using simvastatin with ketoconazole may increase the risk of muscle disorders, including rhabdomyolysis (the breakdown of muscle fibers), so this combination requires careful medical supervision.

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