Ketoconazole Topical: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

Ketoconazole is used to treat skin infections such as athlete’s foot, jock itch, ringworm, and certain kinds of dandruff. This medication is also used to treat a skin condition known as pityriasis (tinea versicolor), a fungal infection that causes a lightening or darkening of the skin of the neck, chest, arms, or legs. Ketoconazole is an azole antifungal that works by preventing the growth of fungus.

How to use ketoconazole topical

Use this medication on the skin only. Clean and thoroughly dry the area to be treated. Apply this medication to the affected skin, usually once or twice a day or as directed by your doctor. Dosage and length of treatment depends on the type of infection being treated. Do not apply this more often than prescribed. Your condition will not clear faster, but side effects may be increased.

Apply enough medication to cover the affected skin and some of the surrounding skin. After applying this medication, wash your hands. Do not wrap, cover or bandage the area unless directed to do so by your doctor.

Do not apply this medication in the eyes, nose, mouth, or vagina. If this medication gets in the eyes (for example, when used to treat dandruff), rinse thoroughly with water.

Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time(s) each day.

Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after starting ketoconazole. Stopping the medication too early may allow the fungus to continue to grow, which may result in a relapse of the infection.

Inform your doctor if your condition lasts after the prescribed amount of treatment or gets worse at any time.

Side Effects

Stinging, swelling, irritation, or redness of the treated skin may occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: blistering, open sores.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using ketoconazole, tell your doctor or pharmacist if you are allergic to it; or to other azole antifungals such as clotrimazole, econazole, or miconazole; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history.

This medication should be used only if clearly needed during pregnancy. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Does ketoconazole topical interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Do not share this medication with others.

This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.

When treating pityriasis, this medication may not cause an immediate return to normal skin color. It may take several months after treatment is completed for your natural skin color to return.

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

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ketoconazole 2 % topical cream

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ketoconazole 2 % topical cream

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ketoconazole 2 % topical cream

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This medicine is a white, cream

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This medicine is a white, cream

ketoconazole 2 % topical cream

Color: whiteShape: Imprint:

This medicine is a white, cream

ketoconazole 2 % topical cream

Color: whiteShape: Imprint:

This medicine is a white, cream

ketoconazole 2 % topical cream

Color: whiteShape: Imprint:

This medicine is a white, cream

ketoconazole 2 % topical cream

Color: whiteShape: Imprint:

This medicine is a white, cream

ketoconazole 2 % topical cream

Color: whiteShape: Imprint:

This medicine is a white, cream

ketoconazole 2 % topical cream

Color: whiteShape: Imprint:

This medicine is a white, cream

ketoconazole 2 % topical cream

Color: whiteShape: Imprint:

This medicine is a white, cream

ketoconazole 2 % topical cream

Color: whiteShape: Imprint:

This medicine is a white, cream

ketoconazole 2 % topical cream

Color: whiteShape: Imprint:

This medicine is a white, cream

ketoconazole 2 % topical cream

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Tinea Versicolor: Cause, Symptoms, and Treatments

Written by WebMD Editorial Contributors

• What Is Tinea Versicolor?
• Signs and Symptoms of Tinea Versicolor
• Tinea Versicolor Causes
• Tinea Versicolor Diagnosis
• Tinea Versicolor Treatment
• Lifestyle Tips for Managing Tinea Versicolor
• More

Tinea versicolor is a fungal infection that causes small patches of discolored spots on your skin. It’s also called pityriasis versicolor. It results from a type of yeast that naturally lives on your skin. When the yeast grows out of control, the skin disease, which appears as a rash, is the result.

Acidic bleach from the growing yeast causes areas of skin to be a different color than the skin around them. These can be individual spots or patches. Specific signs and symptoms of the infection include:

• Pityriasis versicolor. Pityriasis versicolor is a common skin disease caused by yeast-like fungus (Malassezia furfur). The fungus interferes with the normal pigmentation of the skin causing patches of discoloration, usually on the main trunk of the body and shoulders. It can be treated with antifungal creams, lotions, and soaps.

  Patches that are white, pink, red, or brown and may be lighter or darker than the skin around them.

• Spots that don’t tan the way the rest of your skin does.
• Spots that show up more boldly when you do tan.
• Spots that may occur anywhere on your body but are most commonly seen on your neck, chest, back, and arms.
• Spots that are dry and scaly and may itch or hurt, although this is rare.

The spots may disappear during cool weather and get worse during warm and humid weather.

Similar conditions

Some skin problems have symptoms that look like tinea versicolor, including:

• Vitiligo: a disease that makes you lose your skin color
• Pityriasis rosea: a rash that causes small spots that fan out on your body in the shape of a tree

These conditions have features that clue your doctor in to what you have, such as texture and rash pattern.

The yeast that causes tinea versicolor, Malassezia, grows on normal, healthy skin. But these things can trigger an overgrowth that causes the infection:

• Oily skin
• Living in a hot climate
• Sweating a lot
• Hormonal changes
• A weakened immune system

Because the yeast grows naturally on your skin, tinea versicolor isn’t contagious. The condition can affect people of any skin color. It’s more likely to affect teens and young adults. For some people, it can cause emotional distress and feelings of self-consciousness.

Your doctor can diagnose tinea versicolor by what the rash looks like.

If they need more information, these tests can help:

• Wood lamp (black light) examination. The doctor uses ultraviolet light, which may make the affected areas appear a fluorescent coppery orange color if they’re the result of tinea versicolor.
• Microscopy using potassium hydroxide (KOH). Your doctor removes cells from your skin, soaks them in potassium hydroxide, then looks at them under a microscope.
• Skin biopsy. The doctor takes a skin sample by scraping some skin and scales from the affected area to look at under a microscope. With children, the doctor may lift off skin cells by first firmly attaching clear tape to the affected area then removing it. The sample then can be stuck directly onto a slide to look at with a microscope.

Treatment of tinea versicolor can consist of creams, lotions, or shampoos that you put on your skin. It can also include medication given as pills. The type of treatment will depend on the size, location, and thickness of the infected area.

Treatment options include:

• Topical antifungals. You put these directly to your skin. They may be in the form of lotion, shampoo, cream, foam, or soap. They keep yeast growth under control. Over-the-counter anti-fungal topical products containing ingredients such as clotrimazole, ketoconazole, miconazole, zinc-pyrithione, selenium sulfide, and terbinafine are available. Prescription products are available too.
• Antifungal pills. These may be used to treat more serious or recurrent cases of tinea versicolor. Sometimes doctors use them because they clear up the infection faster. You’ll need a prescription for these medicines. They can have side effects. Your doctor will keep an eye on you while you’re taking antifungal pills.

Treatment usually gets rid of the fungal infection. But skin discoloration may take several months to resolve.
 

Episodes are very common because the yeast that causes the infection is a normal fungus that lives on your skin. You might use medicated cleansers once a week for 10 minutes at a time for a few months to help prevent tinea versicolor from coming back. You may need to use these cleansers if the infection keeps returning, especially if you live in a warm and humid area.

To help you manage tinea versicolor you can:

• Avoid using oily skin products.
• Reduce the time you spend in the sun. It may trigger or worsen an episode, and a tan makes the rash more visible.
• Use an anti-fungal shampoo daily for a couple of days prior to sun exposure if you do have to go out.
• Put on sunscreen every day. Use a broad spectrum, nongreasy formula with a minimum sun protection factor (SPF) of 30.
• Try a dandruff shampoo with selenium sulfide.
• Wear loose clothing.
• Choose breathable fabrics, like cotton, to decrease sweating.

Top Picks

Ketoconazole-Phytopharm: instruction, price, analogues | cream for external use Fitofarm

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• Pharmacological properties
• Indications Ketoconazole-Phytopharm
• Application of Ketoconazole-Phytopharm
• Contraindications
• Side effects
• Special instructions
• Interactions
• Overdose
• Storage conditions
• Diagnosis
• Recommended alternatives
• Trade names

Ketoconazole is a synthetic imidazoledioxolane derivative that exhibits antifungal activity against dermatophytes and yeasts. Ketoconazole cream very quickly eliminates the itching that usually accompanies infections caused by dermatophytes and yeasts. After topical application of the cream, ketoconazole in the blood is not determined.

treatment of fungal infections of the skin such as athlete’s foot, athlete’s groin, treatment of candidiasis of the skin folds (intertrigo).

for the treatment of athlete’s foot Ketoconazole-Phytofarm is recommended to be applied to the affected skin and surrounding areas 2 times a day. Usually the duration of treatment of skin lesions is 1 week. For more severe skin lesions, treatment should be continued for another 2-3 days after the disappearance of all symptoms in order to avoid recurrence of the disease.

For the treatment of athlete’s groin and candidiasis of the skin folds, it is recommended to apply the drug to the affected skin and nearby areas 2 times a day. Treatment should last for a sufficient time, at least 2-3 days after the disappearance of all symptoms in order to avoid recurrence of the disease. If necessary, treatment can last up to 6 weeks. If the symptoms of the disease do not disappear after 4 weeks of treatment, you should consult a doctor.

hypersensitivity to ketoconazole or other components of the drug.

adverse reactions that occurred in ≥1% of patients:

general disorders and reactions at the site of application: erythema, itching;

skin and subcutaneous tissue disorders: burning sensation.

Adverse reactions that occurred in <1% of patients:

general disorders and reactions at the site of application: bleeding, discomfort, dryness, inflammation, irritation, paresthesia;

immune system disorders: hypersensitivity reactions;

skin and subcutaneous tissue disorders: bullous rash, contact dermatitis, peeling or stickiness of the skin.

Post-Marketing Surveillance

Adverse reactions with ketoconazole cream first reported post-marketing are listed below. The frequency of occurrence of adverse reactions is distributed as follows: very often – ≥1 / 10; often – ≥1/100 and <1/10; infrequently - ≥1/1000 and <1/100; rarely - ≥1/10,000 and <1/1000; very rare - <1/10,000, including isolated reports:

disorders of the skin and subcutaneous tissue: very rare – urticaria.

Ketoconazole-Phytopharm cream is not used in ophthalmic practice. If Ketoconazole-Fitofarm cream is applied to the affected areas immediately after prolonged treatment with ointments that contain corticosteroids, irritation may occur. In such cases, it is recommended to continue applying topical corticosteroids to the affected areas in the morning and Ketoconazole-Phytopharm cream in the evening. Then you should gradually, over 2-3 weeks, stop corticosteroid therapy.

Propylene glycol may cause itching of the skin. Cetostearyl alcohol may cause local skin reactions (eg contact dermatitis).

Use during pregnancy and lactation. There are no adequate and well-controlled studies of the use of the drug in pregnant women and women who are breastfeeding. The risks associated with the use of the drug during pregnancy and lactation are unknown.

Children. There is no experience of using Ketoconazole-Phytopharm cream in children.

The ability to influence the reaction rate when driving vehicles or working with other mechanisms. No effect.

no interactions with other drugs have been identified.

topical application. Topical application of the cream in excess may cause erythema, edema, skin burning sensation, which quickly disappear after therapy is discontinued.

Accidental ingestion. In case of accidental ingestion, supportive and symptomatic therapeutic measures should be taken.

at a temperature not exceeding 25 °C. Do not freeze.

instructions for use, price, analogues, composition, indications

1 g of cream contains:

Active substance: ketoconazole 20 mg.

Excipients: propylene glycol, cetostearyl alcohol, octyldodecanol,

glycerin, anhydrous sodium sulfite, methyl parahydroxybenzoate, propyl parahydroxybenzoate, purified water.

Uniform white or almost white cream.

Antifungal. It has a fungicidal or fungistatic effect. The mechanism of action is to inhibit the synthesis of ergosterol and change the lipid composition of the membrane. It is active against the causative agent of multi-colored lichen Malassezia furfur, pathogens of some dermatomycosis (Trichophyton sp., Epidermophyton floccosum, Microsporum sp.), Candidiasis pathogens (Candida sp. ), and Pityrosporum sp. Ketoconazole cream acts quickly on itching in dermatophyte and yeast infections, as well as in rut lesions caused by Pityrosporum sp. In this case, symptomatic improvement is observed even before the first signs of recovery appear.

When applied topically, ketoconazole is not absorbed.

Dermatophyte infections of the skin caused by Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum canis and Epidermophyton floccosum: ringworm of the smooth rut, inguinal athlete, epidermophytosis of the hands and feet. Skin candidiasis. Pityriasis versicolor. Seborrheic dermatitis caused by Pityrosporum ovale.

Hypersensitivity to ketoconazole or any of the excipients of the formulation.

Well-controlled safety studies of ketoconazole 2% cream have not been conducted in pregnant and lactating women. The limited data available indicate that there are no adverse effects of the use of the cream on the course of pregnancy or on the health of the fetus / newborn. Animal studies have shown reproductive toxicity at doses not related to topical ketoconazole.

There are currently no known risks associated with the use of Ketoconazole 2% cream during pregnancy or breastfeeding.

Skin candidiasis, ringworm, jock itch, athlete’s foot and hands, pityriasis versicolor: apply the cream once a day to the affected skin and immediately adjacent area.

Seborrheic dermatitis: the cream is applied to the affected area once or twice a day, depending on the severity of the lesion.

Treatment should be continued for a sufficient interval: for several days after the disappearance of all symptoms of the disease. The diagnosis should be re-evaluated if there is no clinical improvement after 4 weeks of treatment.

The usual duration of treatment is as follows: pityriasis versicolor – 2-3 weeks, skin candidiasis – 2-3 weeks, athlete’s groin – 2-4 weeks, ringworm of smooth skin – 3-4 weeks, athlete’s foot – 4-6 weeks.

The usual duration of treatment for seborrheic dermatitis is 2-4 weeks. For maintenance therapy for seborrheic dermatitis, the cream is applied once or twice a week.

Side effects that occur during treatment with ketoconazole are classified depending on the frequency of occurrence in the appropriate groups: very often (> 1/10), often (> 1/100 to 1/1000 to 1/10000 to

Immune system disorders Uncommon: hypersensitivity.

Skin and subcutaneous tissue disorders Common: burning sensation.

Uncommon: bullous rash, contact dermatitis, rash, skin desquamation, oily/dry skin.

Frequency not known: urticaria.

Systemic disorders and complications at the injection site Common: erythema and itching at the injection site.

Uncommon: bleeding, discomfort, dryness, burning, irritation, paresthesia at the site of application.

The use of the cream in excessive amounts may lead to erythema, edema and burning sensation, which usually disappear after therapy is discontinued.

If the cream is accidentally swallowed by children, no special measures are required.

Interaction with other medicinal products has not been observed.

The cream is for external use only. In case of contact with eyes, rinse thoroughly with water. The use of the cream is not contraindicated during pregnancy and lactation.

To prevent withdrawal after discontinuation of long-term treatment with topical corticosteroids, it is recommended that topical corticosteroids be continued in the morning and ketoconazole cream in the evening, followed by gradual withdrawal of steroids over 2-3 weeks.

Use in persons under 18 years of age.

The drug can be used in children from birth.

Influence on the ability to drive a car or other mechanisms

Ketoconazole usually does not affect the ability to drive a car and work with potentially dangerous mechanisms.

15 g of cream in an aluminum tube.