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Nizoral A-D Side Effects

Generic name: ketoconazole topical

Medically reviewed by Last updated on Dec 3, 2023.

Note: This document contains side effect information about ketoconazole topical. Some dosage forms listed on this page may not apply to the brand name Nizoral A-D.

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

Serious side effects of Nizoral A-D

Along with its needed effects, ketoconazole topical (the active ingredient contained in Nizoral A-D) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking ketoconazole topical:

Less common—For cream, shampoo, foam, or gel

Rare—For cream, foam, or gel

Rare—For shampoo

Incidence not known—For gel

Incidence not known—For shampoo

Other side effects of Nizoral A-D

Some side effects of ketoconazole topical may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common—For shampoo or gel

Rare—For shampoo

For Healthcare Professionals

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



-Common (1% to 10%): Skin burning sensation

-Uncommon (0.1% to 1%): Bullous eruption, contact dermatitis, rash, skin exfoliation, sticky skin

-Frequency not reported: Severe irritation, pruritus, stinging, urticaria


-Frequency not reported: Reactions to a photoallergenicity study, contact sensitization

-Postmarketing reports: Skin burning sensation, erythema


-Frequency not reported: Impetigo, pyogenic granuloma, acne, nail discoloration


-Uncommon (0.1% to 1%): Alopecia, dry skin, abnormal hair texture, rash, skin burning sensation, folliculitis

-Rare (0.01% to 0.1%): Acne, contact dermatitis, skin disorder, skin exfoliation

-Frequency not reported: Normal hair loss increased, irritation, scalp pustules, mild skin dryness, oiliness/dryness of hair and scalp, pruritus

-Postmarketing reports: Hair discoloration/hair color changes, itching, angioedema, urticaria, skin irritation[Ref]

Rare reports of contact dermatitis have been associated with the cream or 1 of its excipients (i.e., sodium sulfite or propylene glycol) during postmarketing experience.

Alopecia, dry skin, abnormal hair texture, rash, skin burning sensation, and contact dermatitis have also been reported during postmarketing experience with the shampoo.[Ref]



-Common (1% to 10%): Application site pruritus, application site erythema

-Uncommon (0.1% to 1%): Application site bleeding, application site discomfort, application site dryness, application site inflammation, application site irritation, application site paresthesia, application site reaction


-Common (1% to 10%): Application site burning, application site reaction

-Frequency not reported: Application site reactions (dryness, erythema, irritation, paresthesia, pruritus, rash, warmth)

-Postmarketing reports: Application site pain, application site burn


-Common (1% to 10%): Application site burning

-Frequency not reported: Treatment-related application site reactions (dermatitis, discharge, dryness, erythema, irritation, pain, pruritus, pustules)

-Postmarketing reports: Burning sensation, pain, skin irritation, erythema


-Uncommon (0.1% to 1%): Application site erythema, application site irritation, application site pruritus, application site reaction

-Rare (0.01% to 0.1%): Application site hypersensitivity, application site pustules

Application site reactions have also been reported during postmarketing experience with the shampoo.



-Uncommon (0.1% to 1%): Hypersensitivity

-Frequency not reported: Painful allergic reaction


-Rare (0.01% to 0.1%): Hypersensitivity

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

Nervous system


-Frequency not reported: Headache, dizziness, paresthesia


-Rare (0.01% to 0.1%): Dysgeusia



-Frequency not reported: Eye irritation, eye swelling, keratoconjunctivitis sicca


-Uncommon (0.1% to 1%): Increased lacrimation

-Rare (0.01% to 0.1%): Eye irritation



-Frequency not reported: Facial swelling


-Frequency not reported: Removal of curl from permanently waved hair



-Postmarketing reports: Cheilitis


1. (2002) "Product Information. Nizoral (ketoconazole)." Janssen Pharmaceuticals

2. Cerner Multum, Inc. "UK Summary of Product Characteristics."

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.