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Indications

• Ketoconazole is employed to treat specific severe fungal infections within the body.
• It falls under the category of drugs known as azole antifungals.
• Its mechanism of action involves halting the growth of the fungus.
• However, Ketoconazole should not be utilized for treating fungal infections on the skin and nails due to the potential for serious side effects and drug interactions.
• Discuss alternative medications with your doctor for managing these types of infections.

Dosage and administration

• Before starting ketoconazole, read the Medication Guide provided by your pharmacist thoroughly, and review it each time you refill your prescription. If you have any questions, consult your doctor or pharmacist.
• Take this medication orally as directed by your doctor, typically once daily. It can be taken with or without food, although taking it with food can help reduce stomach upset.
• If you’re also taking an antacid, ensure you take ketoconazole at least 2 hours before or 1 hour after the antacid. Otherwise, ketoconazole may not be absorbed properly into your body. Refer to Drug Interactions for further details.
• The dosage and duration of treatment are determined based on your medical condition, response to treatment, and other medications you may be taking. Inform your doctor and pharmacist about all products you use, including prescription drugs, over-the-counter drugs, and herbal products. For children, dosage may also depend on weight. Treatment duration can vary from several days to several months.
• For optimal effectiveness, maintain a consistent level of this medication in your body by taking it at evenly spaced intervals. To help remember, take it at the same time each day.
• Continue taking ketoconazole until you’ve finished the full prescribed amount, even if symptoms improve within a few days. Stopping the medication prematurely could lead to a recurrence of the infection.
• Inform your doctor if your condition persists or worsens.

Side effects

• Nausea and vomiting may occur while using ketoconazole. If these effects persist or worsen, promptly inform your doctor or pharmacist.
• Remember that this medication has been prescribed because your doctor believes that the benefit to you outweighs the risk of side effects. Many individuals using this medication do not experience serious side effects.
• Notify your doctor immediately if you encounter any serious side effects, such as headache, vision changes, or mental/mood changes (such as depression or thoughts of suicide).
• Although uncommon, high doses of ketoconazole can lead to adrenal gland problems (adrenal insufficiency), decreased testosterone levels, and reduced sperm production. It may also exacerbate existing adrenal gland function issues. Before undergoing surgery, or emergency treatment, or if experiencing a serious illness/injury, inform your doctor or dentist that you are using this medication. Your doctor may conduct blood tests to monitor your adrenal gland function during ketoconazole treatment. These effects typically subside after discontinuing ketoconazole. Notify your doctor immediately if you experience serious side effects such as unusual tiredness, weakness, dizziness upon standing, diarrhea, weight loss, menstrual period changes, decreased sexual interest or ability, or enlarged/tender breasts in men.
• Seek medical assistance promptly if you experience very serious side effects such as fast/irregular heartbeat, severe dizziness, or fainting.
• While rare, a severe allergic reaction to this drug may occur. Seek medical help immediately if you notice symptoms like rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or difficulty breathing.
• This list doesn’t encompass all possible side effects. If you notice any other effects not mentioned here, contact your doctor or pharmacist.

Precautions

• Before taking ketoconazole, inform your doctor or pharmacist if you are allergic to it, levoketoconazole, other azole antifungal drugs (such as fluconazole, itraconazole), or have any other allergies. Inactive ingredients in the product may also cause allergic reactions or other issues.
• Discuss your medical history with your doctor or pharmacist before using this medication, especially if you have liver problems, engage in alcohol use, have low testosterone levels, or experience decreased adrenal gland function problems (such as low cortisol levels, Addison’s disease, adrenal insufficiency), or have little or no stomach acid production (achlorhydria).
• Ketoconazole may lead to a condition affecting heart rhythm known as QT prolongation. This can rarely result in serious (rarely fatal) fast/irregular heartbeat and other symptoms such as severe dizziness or fainting, requiring immediate medical attention.
• The risk of QT prolongation may increase with certain medical conditions or if you are taking other drugs that may cause QT prolongation. Inform your doctor or pharmacist about all the drugs you are taking and whether you have certain heart problems or a family history of such problems.
• Low levels of potassium or magnesium in the blood may also increase the risk of QT prolongation. This risk may be heightened by certain drugs (such as diuretics/”water pills”) or conditions such as severe sweating, diarrhea, or vomiting. Discuss with your doctor about using ketoconazole safely in such situations.
• Prior to undergoing surgery, inform your doctor or dentist about all the products you use, including prescription drugs, nonprescription drugs, and herbal products.
• Avoid alcoholic beverages while taking ketoconazole because alcohol increases the risk of serious liver problems. This also reduces the risk of a rare reaction with ketoconazole that may lead to flushing, headache, and nausea.
• Older adults may be more sensitive to the side effects of ketoconazole, particularly QT prolongation.
• During pregnancy, use this medication only when clearly needed, after discussing the risks and benefits with your doctor.
• Consult your doctor before breastfeeding, as ketoconazole passes into breast milk.