Ketoconazole topical Uses, Side Effects & Warnings

Generic name: ketoconazole topical [ kee-toe-KOE-na-zole ]
Brand names: Extina, Ketodan, Kuric, Nizoral A-D, Nizoral Topical, Xolegel
Dosage forms: topical cream (2%), topical foam (2%), topical gel (2%), topical kit (2% with cleanser), topical shampoo (1%; 2%)
Drug class: Topical antifungals

Medically reviewed by Drugs.com on Mar 7, 2023. Written by Cerner Multum.

What is ketoconazole topical?

Ketoconazole topical (for the skin) is an antifungal medicine used to treat infections such as athlete’s foot, jock itch, ringworm, and seborrhea (dry, flaking skin or dandruff).

Ketoconazole topical is also used to treat a fungal infection called pityriasis, which causes scaly discolored patches on the skin of the neck, chest, arms, or legs.

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

Warnings

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

You should not use ketoconazole topical if you are allergic to ketoconazole.

Ask a doctor or pharmacist if this medicine is safe to use if you have:

• asthma or a sulfite allergy;

• an allergic reaction to an antifungal medicine, such as clotrimazole, econazole, or miconazole.

Ask a doctor before using this medicine if you are pregnant.

You should not breast-feed while using ketoconazole topical.

Always follow directions on the medicine label about using this medicine on a child.

How should I apply ketoconazole topical?

Use exactly as directed on the label, or as prescribed by your doctor.

Using more of this medicine or applying it more often than prescribed will not make it work any faster, and may increase side effects.

Do not take by mouth. Topical medicine is for use only on the skin. Do not use on open wounds or irritated skin. Rinse with water if this medicine gets in your eyes, nose, or mouth.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Wash your hands before and after using this medicine.

Clean and dry the skin before applying ketoconazole cream, foam, or gel.

This medicine may be flammable. Do not use near high heat or open flame, or while smoking. Avoid heat or smoking until the medicine has completely dried on your skin.

Ketoconazole shampoo is not for daily use. Allow at least 3 days to pass between uses.

Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication.

Call your doctor if your symptoms do not begin to improve after 2 to 4 weeks of treatment, or if your condition gets worse.

Store ketoconazole topical at room temperature. Protect from light and do not refrigerate or freeze.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

An overdose of ketoconazole topical is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.

What should I avoid while using ketoconazole topical?

Do not get ketoconazole topical in your eyes. If contact does occur, rinse with water.

Avoid covering treated skin areas with tight-fitting, synthetic clothing (such as nylon or polyester) that doesn’t allow air to circulate to your skin. If you are treating your feet, wear clean cotton socks and sandals or shoes that allow for air circulation. Keep your feet as dry as possible.

You may need to avoid sunlight if you are treating pityriasis. Follow your doctor’s instructions.

Avoid using skin products that can cause irritation, such as harsh soaps, shampoos, hair coloring or permanent chemicals, hair removers or waxes, or skin products with alcohol, spices, astringents, or lime.

Avoid using other medications on the areas you treat with ketoconazole topical unless your doctor tells you to.

Ketoconazole topical side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Ketoconazole topical may cause serious side effects. Call your doctor at once if you have:

• burning, stinging, or severe irritation after using this medicine;

• redness, pain, or oozing of treated skin; or

• shortness of breath.

Common side effects of ketoconazole topical may include:

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.

What other drugs will affect ketoconazole topical?

Medicine used on the skin is not likely to be affected by other drugs you use. But many drugs can interact with each other. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

More about ketoconazole topical

• Compare alternatives
• Pricing & coupons
• Reviews (42)
• Side effects
• Dosage information
• During pregnancy
• Drug class: topical antifungals
• Breastfeeding
• En español

Patient resources

• Advanced Reading
• Ketoconazole Cream
• Ketoconazole Foam
• Ketoconazole Foam and Cleanser Kit
• Ketoconazole Gel

Other brands

Nizoral Topical, Ketodan, Xolegel, Nizoral A-D, . .. +2 more

Professional resources

• Prescribing Information

Related treatment guides

• Seborrheic Dermatitis
• Cutaneous Candidiasis
• Androgenetic Alopecia
• Dandruff

Further information

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.

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

Medical Disclaimer

Copyright 1996-2023 Cerner Multum, Inc. Version: 5.02.

Clinical comparison of the efficacy and tolerability of once daily Canesten with twice daily Nizoral (clotrimazole 1% cream vs. ketoconazole 2% cream) during a 28-day topical treatment of interdigital tinea pedis

Clinical Trial

. 2002 Apr;45(3-4):91-6.

doi: 10.1046/j.1439-0507.2002. 00724.x.

Sigrid Suschka 
¹
, Bernward Fladung, Hans F Merk

Affiliations

Affiliation

• ¹ Department of Dermatology, University Clinic of the RWTH Aachen, Germany.

• PMID:

  12000508

• DOI:

  10.1046/j.1439-0507.2002.00724.x

Clinical Trial

Sigrid Suschka et al.

Mycoses.

2002 Apr.

. 2002 Apr;45(3-4):91-6.

doi: 10.1046/j.1439-0507.2002.00724.x.

Authors

Sigrid Suschka 
¹
, Bernward Fladung, Hans F Merk

Affiliation

• ¹ Department of Dermatology, University Clinic of the RWTH Aachen, Germany.

• PMID:

  12000508

• DOI:

  10.1046/j.1439-0507.2002.00724.x

Abstract

The effects of two topical cream formulations containing clotrimazole 1% and ketoconazole 2%, respectively, were clinically compared in a double-blind, randomized manner for a 28-day therapy of interdigital tinea pedis in 106 treated patients. Ketoconazole was to be used twice daily whereas clotrimazole was administered only once daily. The primary response criterion defined as the number of patients with cure or improvement after 28 treatment days was comparable with 62.0% vs. 64.0% (clotrimazole vs. ketoconazole) for the full analysis set of 100 (50 vs. 50) patients. The mycological response revealed a negative culture and microscopy in 53. 1% vs. 52.1% of the patients after 14, in 76.0% vs. 79.2% after 28, and in 83.7% vs. 76.9% after 56 days of observation, indicating a possibly better long-term efficacy of clotrimazole. The development of the overall score of tinea-related signs and symptoms did not show relevant differences between the two drugs and continuously decreased from 11+/-5 in both groups at baseline to 2+/-2 vs. 2+/-1 at day 56. As to the remission and improvement rates of single symptoms, better results were obtained under clotrimazole than under ketoconazole particularly for pruritus (97.8 vs. 89.6%) and burning/stinging (97.5 vs. 89.4%) which both are perceived as most bothersome by the patients. Furthermore, both substances appeared as comparably safe and well tolerable (8 vs. 7 adverse events with only 1 vs. 3 drug related). In conclusion, a successful therapy of tinea pedis can be achieved with both clotrimazole and ketoconazole within 28 days of treatment and once-daily clotrimazole is equally effective as twice-daily ketoconazole with favourable influences on the most irritating symptoms of the disease. Mycological and reliable clinical cure cannot be observed during two weeks after start of treatment.

Similar articles

• Comparison of one week of oral terbinafine (250 mg/day) with four weeks of treatment with clotrimazole 1% cream in interdigital tinea pedis.

  Barnetson RS, Marley J, Bullen M, Brookman S, Cowen P, Ellis D, Williams T.

  Barnetson RS, et al.
  Br J Dermatol. 1998 Oct;139(4):675-8. doi: 10.1046/j.1365-2133.1998.02466.x.
  Br J Dermatol. 1998.

  PMID: 9892913

  Clinical Trial.

• Comparison of terbinafine and clotrimazole in treating tinea pedis.

  Evans EG, Dodman B, Williamson DM, Brown GJ, Bowen RG.

  Evans EG, et al.
  BMJ. 1993 Sep 11;307(6905):645-7. doi: 10.1136/bmj.307.6905.645.
  BMJ. 1993.

  PMID: 8401048
  Free PMC article.

  Clinical Trial.

• A comparison of terbinafine (Lamisil) 1% cream given for one week with clotrimazole (Canesten) 1% cream given for four weeks, in the treatment of tinea pedis.

  Evans EG.

  Evans EG.
  Br J Dermatol. 1994 Apr;130 Suppl 43:12-4. doi: 10.1111/j.1365-2133.1994.tb06086.x.
  Br J Dermatol. 1994.

  PMID: 8186134

  Clinical Trial.

• Tinea pedis: clinical experience and efficacy of short treatment.

  Evans EG.

  Evans EG.
  Dermatology. 1997;194 Suppl 1:3-6. doi: 10.1159/000246173.
  Dermatology. 1997.

  PMID: 9154392

  Review.

• Terbinafine. An update of its use in superficial mycoses.

  McClellan KJ, Wiseman LR, Markham A.

  McClellan KJ, et al.
  Drugs. 1999 Jul;58(1):179-202. doi: 10.2165/00003495-199958010-00018.
  Drugs. 1999.

  PMID: 10439936

  Review.

See all similar articles

Cited by

• Efficacy and Safety of Terbinafine Hydrochloride 1% Cream vs. Sertaconazole Nitrate 2% Cream in Tinea Corporis and Tinea Cruris: A Comparative Therapeutic Trial.

  Choudhary S, Bisati S, Singh A, Koley S.

  Choudhary S, et al.
  Indian J Dermatol. 2013 Nov;58(6):457-60. doi: 10.4103/0019-5154.119958.
  Indian J Dermatol. 2013.

  PMID: 24249898
  Free PMC article.

• Topical treatments for fungal infections of the skin and nails of the foot.

  Crawford F, Hollis S.

  Crawford F, et al.
  Cochrane Database Syst Rev. 2007 Jul 18;2007(3):CD001434. doi: 10. 1002/14651858.CD001434.pub2.
  Cochrane Database Syst Rev. 2007.

  PMID: 17636672
  Free PMC article.

  Review.

• Transcriptional profiles of the response to ketoconazole and amphotericin B in Trichophyton rubrum.

  Yu L, Zhang W, Wang L, Yang J, Liu T, Peng J, Leng W, Chen L, Li R, Jin Q.

  Yu L, et al.
  Antimicrob Agents Chemother. 2007 Jan;51(1):144-53. doi: 10.1128/AAC.00755-06. Epub 2006 Oct 23.
  Antimicrob Agents Chemother. 2007.

  PMID: 17060531
  Free PMC article.

• Dermatology for the practicing allergist: Tinea pedis and its complications.

  Al Hasan M, Fitzgerald SM, Saoudian M, Krishnaswamy G.

  Al Hasan M, et al.
  Clin Mol Allergy. 2004 Mar 29;2(1):5. doi: 10.1186/1476-7961-2-5.
  Clin Mol Allergy. 2004.

  PMID: 15050029
  Free PMC article.

• In vitro activities of the new antifungal drug eberconazole and three other topical agents against 200 strains of dermatophytes.

  Fernández-Torres B, Inza I, Guarro J.

  Fernández-Torres B, et al.
  J Clin Microbiol. 2003 Nov;41(11):5209-11. doi: 10.1128/JCM.41.11.5209-5211.2003.
  J Clin Microbiol. 2003.

  PMID: 14605165
  Free PMC article.

Publication types

MeSH terms

Substances

instructions for use, dosage, composition, analogues, side effects / Pillintrip

What should I know before using this medicine?

Precautions and warnings for ketoconazole

Warnings

Tell your doctor if you are taking other medicines, as you are taking them at the same time ketoconazole with other medicines it may be harmful. Make sure you report any medications you are taking, whether or not prescribed by a doctor, including supplements and natural products.

During treatment with ketoconazole tablets may occur in liver disease, even with short treatments. However, this is more likely to happen if you know you have liver problems. You can recognize liver disorders by the following symptoms: dark urine, whitish stools, yellowish skin, yellowish whites, abdominal pain, unusual tiredness, and/or fever. In this case, treatment with Ketoconazole Tablet should be suspended and reported to your physician immediately.

Before you start treatment with Ketoconazole Tablet, your doctor will order blood tests to make sure your liver is functioning properly. If you are being treated with Ketoconazole Tablets, if they are distributed, your doctor will order blood tests to check for liver problems in the early stages of bleeding.

Cases of severe hepatotoxicity, including death or cases requiring liver transplantation, have occurred with oral ketoconazole.

Some patients did not have a risk factor for liver development. There are reports of occurrence within a month of treatment, including in the first week.

Accumulation of therapeutic doses is considered a risk factor for severe hepatotoxicity.

Adrenal function should be monitored in patients with no or normal adrenal function, in addition to patients with prolonged periods of stress (major surgery, intensive care) and in patients on long-term therapy who have signs and symptoms suggestive of lack of adrenal function.

When gastric acidity decreases, the absorption of ketoconazole decreases. If you have decreased stomach acid due to a medical condition, such as achlorhydria, or medication that reduces stomach acid, it is recommended that you take ketoconazole tablets with an acidic drink (such as non-diet cola soda). Your doctor will monitor antifungal activity and evaluate the need to increase the dose of Ketoconazole .

Influence on the ability to drive vehicles and drive machines.

Compressed ketoconazole is unlikely to affect the ability to drive and operate machines.

General hygiene measures should be followed to control sources of infection and reinfection.

Use in special populations

Pediatric use

Documented use of ketoconazole tablet in children weighing less than 15 kg is very limited.

Therefore use 9Ketoconazole 0007 tablet is not recommended in young children.

Drug Interactions Ketoconazole

Some people feel unwell when they drink alcoholic beverages during treatment with ketoconazole tablet. Therefore, you should not drink alcoholic beverages during treatment with Ketoconazole Tablet.

To do this, there must be enough acid in the stomach. ketoconazole tablet is absorbed correctly. Therefore, drugs that neutralize stomach acid should be taken at least one hour before ketoconazole tablet or should not be taken until two hours after taking ketoconazole tablet. For the same reason, if you are using medicines that suppress stomach acid production, you should take her ketoconazole glue soda tablet.

Tell your doctor what medicines you are currently taking. In particular, there are some medicines that you should not take during the same period, while others require some changes.

Medicines not to be taken during treatment ketoconazole tablet:

– certain allergy medicines: terfenadine, astemizole and mizolastine;

-halofantrine, a medicine used to treat malaria;

– certain medicines to treat severe pain or addiction: levacetylmethadol (levomethadil), cisapride methadone, a medicine used for certain digestive problems;

– dosperidone, a medicine used for nausea, vomiting and discomfort associated with both decreased gastric emptying and reflux of acid from the stomach into the esophagus.

– some cholesterol-lowering drugs: simvastatin and lovastatin;

certain sleeping pills: midazolam, triazolam;

– certain drugs used in psychotic disorders: lurasidone, pimozide, sertindole;

– certain drugs used to treat palpitations: quinidine, disopyramide, dronedarone, dofetilide;

– certain drugs used to treat angina (prolongation of chest pain) or high blood pressure: bepridil, felodipine, eplerenone, licanidipine, ivabradine, ranolazine, nisoldipine;

– drugs known as ergot alkaloids: ergotamine or dihydroergotamine, used to treat migraine;

medicines known as ergot alkaloids: ergometrine (ergonovine) or methylergometrine (methylergonovine), used to control bleeding and maintain uterine contractions after childbirth;

– irinotecan, a cancer drug;

-colcichina, medicine for the treatment of gout, when used in patients with kidney or liver failure.

Wait at least a week after finishing treatment with ketoconazole tablet before taking any of these medicines.

Medicines that can reduce the effect ketoconazole tablet, such as:

– certain drugs used to treat epilepsy: carbamazepine, phenytoin;

– certain preparations for the treatment of tuberculosis: rifampicin, rifabutin, isoniazid;

– certain medicines for the treatment of HIV / AIDS: efavirenz, nevirapine.

Therefore, you should always inform your doctor if you are using any of these products so that appropriate measures can be taken. Wait at least 2 weeks after stopping treatment with these medicines before taking ketoconazole tablet.

Medications are not recommended unless your doctor says it is necessary, for example:

– certain drugs used to treat cancer: dasatinib, nilotinib, sunitinib, trabectin;

– rifabutin, a medicine for the treatment of tuberculosis;

– carbamazepine, a medicine for the treatment of epilepsy;

– colchicine, medicine for the treatment of gout;

-everolimo, a drug administered after organ transplantation;

fentanyl, a strong opioid for the treatment of pain;

– certain drugs that reduce blood clotting: apixaban, rivaroxaban;

-salmeterol, a medicine that improves breathing;

– tansulosin, a medicine for the treatment of urinary incontinence in men;

Vardenafil, a drug for the treatment of erectile dysfunction.

Wait at least 1 week after finishing treatment with ketoconazole tablet before starting these medicines, unless your doctor feels it is necessary to take them.

Medicines that may require a dose or dose change ketoconazole or other medicines such as:

– certain drugs that reduce blood clotting: coumarins, cilostazol, dabigatran;

-methylprednisolone, budesonide, cyclonide, fluticasone or dexamethasone, drugs for inflammation in the body, asthma and allergies, by mouth, injection or inhalation;

-cyclosporine, tacrolimus, surfactant or rapamycin (also known as sirolimus), which are usually administered after organ transplantation;

– some medicines used to treat HIV/AIDS: maravica and protease inhibitors indinavir, ritonavir, darunavir with ritonavir booster, fosamprenavir with ritonavir, and saquinavir booster;

– certain drugs used to treat cancer: vinca alkaloids, busulfan, docetaxel, erlotinib, ixabilone, lapatinib, trimetrexate, bortezomib and imatinib;

– certain medicines for anxiety or sleep (tranquilizers): buspirone, perospirano, ramelteon, IV midazolam, alprazolam, brotizolam;

– certain drugs for the treatment of erectile dysfunction: sildenafil, tadalafil;

– certain medicines for the treatment of allergies: bilabastin, ebastine;

atorvastatin, a medicine used to lower cholesterol;

– reboxetine used to treat depression;

– certain strong analgesics: alfentanil, buprenorphine, oxycodone and sufentanil;

– electriptan used in migraine;

– certain drugs for the treatment of diabetes: repaglinide, saxagliptin;

repressive medicine for the treatment of nausea and vomiting;

– praziquantel, medicine for the treatment of fasciolosis and teniasis;

– cinacalcet, a drug for the treatment of an overactive parathyroid gland;

– certain medicines for the treatment of low sodium levels in the blood: mozavaptan, tolvaptan;

– certain drugs for the treatment of psychosis: aripiprazole, haloperidol, quetiapine, risperidone;

-alitretinoin (oral formulation), medicine for the treatment of eczema.

If you are using any of these medicines, please discuss this with your doctor.

Use of ketoconazole during pregnancy and lactation

The risk of using ketoconazole in pregnant women is not known. Therefore, this medicine should not be taken during pregnancy unless the benefit to the mother outweighs the risk to the fetus.

If you are pregnant or suspected to be pregnant tell your doctor as he will decide if you can take his ketoconazole tablet.

Breastfeeding

You should not breastfeed if you are taking small amounts of ketoconazole tablet Ketoconazole may be present in breast milk.

This medicine should not be used by pregnant women without medical advice or from their dentist.

Tell your doctor or dentist if you are taking any other medicines.

Do not use medicines without the knowledge of your doctor. This may be hazardous to your health.

Lichen in cats Dermatology Articles