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Generic Name: ketoconazole (KEE toe KON a zole)
Brand Name: Nizoral

What is ketoconazole?

Ketoconazole is an antifungal medication that fights infections caused by fungus.

Ketoconazole is not for use in treated fungal infections of the fingernails or toenails. This medicine is also not for use in treating prostate cancer or Cushing syndrome.

This medicine should be used only when you cannot use other antifungal medications. Ketoconazole can cause serious harm to your liver that may result in liver transplant or cause death.

Ketoconazole may also be used for purposes not listed in this medication guide.

What is the most important information I should know about ketoconazole?

This medicine should be used only when you cannot use other antifungal medications. Ketoconazole can cause serious harm to your liver that may result in liver transplant or cause death.

Call your doctor at once if you have any signs of liver damage, such as nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

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Some medicines can interact with ketoconazole and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs: alprazolam, cisapride, dihydroergotamine, disopyramide, dofetilide, dronedarone, eplerenone, ergotamine, lovastatin, methadone, midazolam, nisoldipine, pimozide, quinidine, ranolazine, simvastatin, or triazolam. Certain drug interactions can cause life-threatening irregular heartbeats.

Call your doctor right away if you have a headache with chest pain and severe dizziness, and fast or pounding heartbeats.

What should I discuss with my healthcare provider before taking ketoconazole?

You should not use ketoconazole if you are allergic to it, or if you have liver disease.

Some medicines can interact with ketoconazole and should not be used at the same time. Certain drug interactions can cause life-threatening irregular heartbeats. Your doctor may need to change your treatment plan if you use any of the following drugs:

  • alprazolam, midazolam, or triazolam;

  • cisapride or pimozide;

  • dihydroergotamine or ergotamine;

  • disopyramide, dofetilide, dronedarone, eplerenone, nisoldipine, quinidine, or ranolazine;

  • lovastatin or simvastatin; or

  • methadone.

To make sure ketoconazole is safe for you, tell your doctor if you have:

  • any history of liver problems;

  • problems with your adrenal gland;

  • personal or family history of long QT syndrome; or

  • if you also use certain antibiotics, heart rhythm medication, migraine headache medicine, anti-malaria medication, or medicine to treat depression or mental illness.

FDA pregnancy category C. It is not known whether ketoconazole will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Ketoconazole can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Do not give this medicine to a child without medical advice.

How should I take ketoconazole?

Your doctor will perform blood tests to make sure you do not have conditions that would prevent you from safely using ketoconazole.

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

While using ketoconazole, you may need frequent blood tests to check your liver function.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Ketoconazole will not treat a viral infection such as the common cold or flu.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking ketoconazole?

Avoid taking antacids, stomach acid reducers, or medicines to treat stomach ulcer or gastroesophageal reflux disease (Axid, Nexium, Pepcid, Prevacid Prilosec, sucralfate, Tagamet, Zantac, and others). These medications can make it harder for your body to absorb ketoconazole.

Avoid drinking alcohol. It may increase your risk of liver damage while you are taking ketoconazole.

Ketoconazole side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; fever; difficulty breathing, chest pain; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

  • unusual weakness or tired feeling, nausea and vomiting; or

  • liver problems--upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

Common side effects may include:

  • mild nausea or stomach pain;

  • diarrhea; or

  • headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect ketoconazole?

Many drugs can interact with ketoconazole. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with ketoconazole. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about ketoconazole.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 11.01. Revision Date: 2014-06-30, 2:40:35 PM.

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