Ketoconazole

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 24.04.2021

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Synonym(s)

Ketoconazole

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DefinitionThis section has been translated automatically.

Imidazole antifungal.

Half-lifeThis section has been translated automatically.

2 h or 6-10 h (metabolites).

Pharmacodynamics (Effect)This section has been translated automatically.

Inhibition of the ergosterol synthesis of the fungal cell membrane of dermatophytes, yeasts and moulds.

IndicationThis section has been translated automatically.

Mycoses of the skin, hair and mucous membrane, caused by dermatophytes, candida and other pathogens. Organ and system mycoses, fungal prophylaxis, chronic recurrent vaginal mycoses.

Limited indicationThis section has been translated automatically.

Diabetes mellitus, nursing.

Dosage and method of useThis section has been translated automatically.

  • Topical:
    • Mycoses and candidoses of the skin: Apply cream thinly to the affected areas 1-2 times/day for 2-3 weeks or apply solution once/day for max. 5 days.
    • Seborrheic eczema: Cream: Apply 2 times/day for 4 weeks on the affected areas. Solution: 2 times/week for 2-4 weeks, apply half a cap to damp hair, massage in, leave on for 3-5 minutes, then rinse with warm water. To prevent recurrence, apply at 1-2 weekly intervals for 4 months.
  • Systemic:
    • 1 time a day 200 mg p.o. for 1-2 months.
    • Vaginal mycoses: 1 time per day 400 mg p.o. for 5-10 days.
    • Children from 2 years up to 20 kg KG: once/day 50 mg p.o.
    • Children up to 30 kg KG: once/day 100 mg p.o.

Remember! Exclude pregnancy by pregnancy test before the therapy. Women of childbearing age must use effective contraception during the therapy!

Standard concentrationThis section has been translated automatically.

2% as cream or solution.

Undesirable effectsThis section has been translated automatically.

InteractionsThis section has been translated automatically.

s. Table 1.

ContraindicationThis section has been translated automatically.

  • Topical: Use on the eye, imidazole hypersensitivity.
  • Systemic: Imidazole hypersensitivity, chron. alcohol abuse, acute or chronic liver disease, pregnancy, prostate cancer.

PreparationsThis section has been translated automatically.

Nizoral®, Terzolin®

TablesThis section has been translated automatically.

Main interactions of ketoconazole

Alcohol

Disulfiram-like reactions

Antacids

Ketoconazole level ↓ (to be taken at 2-hour intervals)

Anticoagulants, oral

Bleeding tendency ↑

Barbiturates

Avoid combination, increased hang-over

Ciclosporin A

Ciclosporin levels ↑

Didanosine

Didanosine effect ↓ (take ketoconazole 2 hours before didanosine)

Isoniazid

Ketoconazole levels ↓

Phenytoin

Phenytoin level ↑, Ketoconazole level ↓

Prednisolone

Prednisolone mirror ↑

Rifampicin

reciprocal effect ↓ (take in 12 hours interval)

Theophyllins

Theophylline toxicity ↑

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Last updated on: 24.04.2021