Ketoconazole

What is ketoconazole?

Ketoconazole (also called Nizoral^®) is used to treat fungal infections. It is available as a 200-mg white tablet taken by mouth. It is also available as a white cream that is applied to the affected area of skin, and as a red-orange liquid shampoo that is applied to the scalp to control dandruff.

Possible side effects of ketoconazole

For shampoo only

• Removal of curl from permanent wave
• Hair loss
• Dry skin
• Itching

For skin cream only

• Irritated skin
• Itching
• Stinging
• Irritated scalp

For oral tablets only

Early

• Nausea and vomiting
• Stomach upset

Later (usually more than a day after treatment starts)

• Constipation
• Diarrhea
• Temporary changes in liver function
• High blood pressure
• Itching
• Rash
• Feeling dizzy
• Headache
• Increase in the size of the breasts and breast tenderness may occur in men

These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.

In case of a severe side effect or reaction, call the doctor, nurse, or pharmacist at 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected.

Special instructions for ketoconazole

• If stomach upset occurs, take ketoconazole with food.
• The staff will draw blood samples regularly to check for liver function changes.
• If you have unusual fatigue, nausea, and vomiting, loss of appetite, yellowing of eyes or skin, dark urine, or pale stools, tell your doctor right away. These symptoms could mean that ketoconazole is severely affecting the liver.
• Ketoconazole may affect the way many other medicines work. These medicines include:
  • Oral medicines for diabetes
  • Warfarin
  • Phenytoin
  • Medicines used to suppress the immune system in transplant patients: cyclosporine, sirolimus, tacrolimu
  • Digoxin
  • Midazolam
  • Theophylline
  • Methylprednisolone
  • These and other chemotherapy medicines: vincristine, etoposide, daunorubicin, doxorubicin, idarubicin, mitoxantrone, ifosfamide, and cyclophosphamide.
• Several medicines can affect how ketoconazole works. These medicines include: antacids, ranitidine, famotidine, sucralfate, isoniazid, and rifampin.
• Always give a complete list of medicines you are taking to your doctor or pharmacist. Check with your doctor or pharmacist before starting any new vitamins, herbals, or other medicines while you are taking ketoconazole.
• Follow these guidelines if you are using the shampoo:
  • Avoid contact with the eyes
  • Apply the shampoo to the damp skin of the affected and surrounding areas
  • Lather, wait for 5 minutes, and then rinse with water