Ketoconazole

Generic Details

Generic Name

Ketoconazole

Other Names

  • Nizoral
  • Ketoderm
  • Extina

Drug Class

  • Antifungal

Chemical Formula

C26H28CI2N4O4

Molecular Weight

531.427 g/mol

Mechanism of Action

  • Inhibits the synthesis of ergosterol, disrupting the fungal cell membrane

Indications

  • Fungal infections such as candidiasis, ringworm, pityriasis versicolor, and seborrheic dermatitis

Common Dosage Forms

  • Tablet
  • Cream
  • Shampoo

Typical Dosage

  • 200-400 mg orally once daily for systemic infections
  • 2% cream applied once daily for skin infections

Pediatric Dosage

  • Dosage based on weight and condition; consult pediatrician

Geriatric Dosage

  • Dosage adjustment may be needed; consult healthcare provider

Side Effects

  • Nausea
  • Vomiting
  • Abdominal pain
  • Headache
  • Rash
  • Liver problems

Contraindications

  • Hypersensitivity to ketoconazole
  • Co-administration with certain medications like simvastatin, colchicine

Pregnancy Category

  • C - Use with caution if benefits outweigh risks

Lactation Safety

  • Probably compatible with breastfeeding; limited data available

Drug Interactions

  • Warfarin
  • Cyclosporine
  • Statins
  • Antacids
  • Midazolam

Overdose Symptoms

  • Nausea
  • Vomiting
  • Abdominal pain
  • Dizziness
  • Confusion

Antidote for Overdose

  • No specific antidote; symptomatic treatment

Storage Conditions

  • Store at room temperature away from moisture and heat

Pharmacokinetics

  • Absorption: Well absorbed orally, better absorbed in acidic conditions
  • Distribution: Highly protein-bound
  • Metabolism: Hepatic via CYP3A4
  • Excretion: Mainly in feces

Precautions

  • Monitor liver function tests during treatment
  • Avoid alcohol consumption

Warnings

  • Risk of severe hepatic toxicity
  • Potential for adrenal insufficiency

Others

  • Avoid use in patients with a history of liver disease or abnormalities