Ketoconazole

Ketoconazole is a medicine used to treat fungal infections. These include infections on the skin and in the body, including in the mouth, throat or lungs. Ketoconazole comes as a tablet or shampoo. It's best to take ketoconazole with meals and at bedtime because it can upset your stomach. You can drink alcohol while you're taking ketoconazole tablets – but it may make you feel sleepy so it's best to avoid driving and using tools or machinery if you think this might affect you. 

What is Ketoconazole?
  • Ketoconazole is a medication used to treat fungal infections. These include skin diseases such as ringworm and athlete's foot, yeast infections of the mouth or vagina (also known as thrush), and certain lung diseases. Ketoconazole may also be used to treat hair loss or enlarged prostate gland.

What are the key benefits of taking ketoconazole?
  • Decreasing itching caused by fungal infections on your skin or scalp
  • Treating vaginal yeast infections (candidiasis) in women—including those that are recurrent
  • Ketoconazole is used for the treatment of skin, hair, and nail fungus infections. It works by killing fungi and yeasts that cause these infections.

Who can and cannot use ketoconazole?
  • People who are allergic to ketoconazole or any of its ingredients.
  • Pregnant or breastfeeding women.
  • People with liver disease, kidney disease, heart failure — in other words, if you have any health conditions that require you to take drugs that prevent organ rejection after transplantation surgery.

How and when to use ketoconazole?
  • To use ketoconazole, you should: Wash and dry your hands.
  • Open the package containing ketoconazole cream. Do not touch the applicator tip to anything or anyone while you are opening the package or applying the cream, as it could contaminate both the applicator tip and anything else that it comes into contact with.
  • Take care to avoid contaminating your eyes, nose, mouth or open cuts on your skin while using ketoconazole. If any of these areas come in contact with ketoconazole, wash them thoroughly with soap and water immediately after exposure to the product.


Formulation for ketoconazole
  • Ketoconazole can be applied topically or taken orally in tablet form. Topical forms include creams, lotions, and foams that are applied directly to affected areas on the skin; these products usually come with instructions on how much should be used at a time and how often treatment should continue before it's re-evaluated again by a health professional. 
  • Oral forms include tablets that are taken daily by mouth; these are most useful for treating vaginal yeast infections since topical treatments may have side effects like burning sensations during urination after being applied near the urethra opening at its base where urine leaves your body during urination flow stream exit point exit points endpoint endpoints entry points entries

Tablets
  • The tablets are taken by mouth. They can be taken with or without food.
  • You should take the tablets once a day for 3 to 6 months, depending on the strength of your infection.
  • If you have diabetes, your doctor may prescribe other medicines (such as insulin) if you take ketoconazole tablets. These medicines need to be taken at different times of day, so make sure that you know what time they should be ingested each day, and don't forget!
  • One way to remember this is by saying: "The doctor prescribed two medicines - one was in a purple vial and the other was in a green one." Hint: these were two different types of drugs used together (one for fungal infections).

Shampoo
  • To use shampoo, wash your hair with it twice a week for 5 minutes. Rinse thoroughly and wait 15 minutes before getting wet again to allow the shampoo to dry on your scalp. Do not use it more than twice a week or for longer than two weeks at a time.

Cream
  • Cream is used to treat fungal infections of the skin. It is applied to the affected area of skin.
  • Ketoconazole cream works by stopping the growth of fungi and yeast that cause ringworm, athlete's foot, jock itch and other fungal infections of the skin.
  • Side effects of ketoconazole


Side effects of ketoconazole
  • Headache
  • Dizziness (feeling faint)
  • Increased sweating or skin flushing (reddening)

How do cope with the side effects of ketoconazole?
  • You can treat your side effects by changing the way you use ketoconazole. For example, if you are having trouble breathing while using this medication, try using it less often or take a break from using it. If you are having a hard time sleeping because of the shampoo, wash your hair before bedtime instead of in the morning.
  • If these changes do not make your symptoms go away or if they get worse, talk with your doctor about other ways to manage them.

Pregnancy and Breastfeeding
  • Ketoconazole is not recommended for use during pregnancy. Because of the risk of birth defects, ketoconazole is also not recommended for use during breastfeeding (Langman and MacKay, 1996).
  • Ketoconazole may be used to treat fungal infections in children older than 2 years old with no serious medical conditions or pregnant women who are at least 12 weeks pregnant (CDC, 2016).

Cautions with other medicines
  • Ketoconazole can interact with some other medicines, including certain HIV medicines, certain heart medicines, certain antibiotics, and certain other medicines.
  • To make sure this medicine is safe for you use caution when taking ketoconazole if your doctor has told you that an organ in your body is damaged or weakened (for example due to a recent transplant). If so talk with the doctor before taking ketoconazole.

Conclusion
Ketoconazole should be used only when other medications, such as topical antifungal creams or oral antifungal tablets, have not worked. It is not recommended for the first-line treatment of fungal skin infections. You should always take the dose and amount that you have been prescribed by your doctor to make sure you get all the benefits without causing any unwanted effects. If you need to discontinue this medicine, it is important that you consult your doctor before doing so as your symptoms may get worse if you stop using ketoconazole too soon.

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