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Extina Side Effects

Generic Name: ketoconazole topical

Note: This page contains information about the side effects of ketoconazole topical. Some of the dosage forms included on this document may not apply to the brand name Extina.

For the Consumer

Applies to ketoconazole topical: topical cream, topical foam, topical gel/jelly, topical shampoo, topical solution

In addition to its needed effects, some unwanted effects may be caused by ketoconazole topical (the active ingredient contained in Extina). In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking ketoconazole topical:

Less common—For cream, shampoo, foam, or gel
  • Itching, stinging, burning, or irritation not present before use of this medicine
Rare—For cream, foam, or gel
  • Acne
  • bleeding from sore in the mouth
  • blistering, crusting, irritation, itching, or reddening of the skin
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • cracked, dry, or scaly skin
  • discoloration of the fingernails or toenails
  • dizziness
  • eye dryness, irritation, or swelling
  • red rash with watery, yellow-colored, or pus filled blisters with or without thick yellow to honey-colored crusts
  • skin dryness, pain, rash, redness, or swelling
  • sore in the mouth or on the gums
  • swelling of the face
Rare—For shampoo
  • Hair loss and irritation
Incidence not known—For gel
  • Pain
Incidence not known—For shampoo
  • Blistering, burning, crusting, dryness, or flaking of the skin
  • burning sensation of the skin
  • burning, itching, redness, skin rash, swelling, or soreness at the application site
  • discoloration of the hair
  • dry skin
  • fast heartbeat
  • fever
  • hives
  • hoarseness
  • irritation
  • itching, scaling, severe redness, or soreness of the skin
  • joint pain, stiffness, or swelling
  • rash
  • shortness of breath
  • swelling of the eyelids, face, lips, hands, or feet
  • thinning of the hair
  • tightness in the chest
  • troubled breathing or swallowing
  • wheezing

Minor Side Effects

Some of the side effects that can occur with ketoconazole topical may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common—For shampoo or gel
  • Dryness or oiliness of the hair and scalp
  • headache
Rare—For shampoo
  • Abnormal hair texture
  • mild dryness of the skin
  • scalp pustules

For Healthcare Professionals

Applies to ketoconazole topical: topical cream, topical foam, topical gel, topical kit, topical shampoo


Frequency not reported:
-Cream: Severe irritation, pruritus, stinging
-Foam: Reactions to a photoallergenicity study, contact sensitization
-Gel: Impetigo, pyogenic granuloma, acne, nail discoloration, potential to cause irritation
-Shampoo: Oily hair texture, scalp pustules, mild dryness of the scalp

Postmarketing reports:
-Cream: Contact dermatitis
-Shampoo: Hair discoloration, abnormal hair texture, itching, skin burning sensation, contact dermatitis, alopecia, rash, urticaria, skin irritation, dry skin[Ref]

Rare reports of contact dermatitis have been associated with ketoconazole cream or one of its excipients, namely sodium sulfite or propylene glycol, during postmarketing experience.[Ref]


Frequency not reported:
-Cream: Painful allergic reaction (unspecified)

Postmarketing reports:
-Shampoo: Hypersensitivity reactions (including anaphylaxis), angioedema[Ref]


Very common (10% or more):
-Foam: Application site burning (10%)

Common (1% to 10%):
-Foam: Application site reaction (6%)
-Gel: Application site burning (4.2%)

Uncommon (0.1% to 1%):
-Foam: Application site reactions (dryness, erythema, irritation, paresthesia, pruritus, rash, warmth; 1% or less)
-Gel: Treatment-related application site reactions (dermatitis, discharge, dryness, erythema, irritation, pain, pruritus, pustules; less than 1%)

Postmarketing reports:
-Burning sensation, pain, skin irritation, erythema
-Shampoo: Application site reactions

Nervous system

Common (1% to 10%):
-Gel: Headache (1.1%)

Uncommon (0.1% to 1%):
-Gel: Dizziness (less than 1%), paresthesia (less than 1%)


Uncommon (0.1% to 1%):
-Gel: Eye irritation (less than 1%), eye swelling (less than 1%), keratoconjunctivitis sicca (less than 1%)


Frequency not reported:
-Gel: Facial swelling
-Shampoo: Removal of the curl from permanently waved hair


1. "Product Information. Nizoral (ketoconazole)." Janssen Pharmaceutica, Titusville, NJ.

Not all side effects for Extina may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.