Ketoconazole: functions, dosage, side effects, how to use

What drug ketoconazole?

What is the drug Ketoconazole for?

Ketoconazole is a drug used to treat certain fungal infections of the body. This drug belongs to the class of azole antifungal which works by stopping the growth of the fungus.

Ketoconazole should not be used to treat infections of the brain or nails. This drug can be used to treat advanced prostate cancer.

What are the rules for using ketoconazole?

Take the medicine as directed by your doctor, usually once a day. This medicine is taken before or after meals. Drinking it after meals can help you avoid stomach upset.

If you are taking an antacid medication, use Ketoconazole at least 2 hours before or 1 hour after using an antacid. When taken together, these drugs may not be absorbed by the body.

The dosage and length of therapy will usually be adjusted based on your health condition and response to treatment. For children, the dose given will also take into account body weight. Typically, treatment with ketoconazole lasts a few days to months.

This medication works best if you take it on time each time you drink it. That is why it is important that you take this medicine at the same time every time you take it.

Take this medication until prescribed runs out, even though the symptoms have disappeared for several days. Too soon to stop taking medication can make the infection come back.

If your condition does not improve or even gets worse, consult a doctor immediately.

Follow the rules given by your doctor or pharmacist before starting treatment. If you have any questions, consult your doctor or pharmacist.

How to store ketoconazole?

This medication is best stored at room temperature, away from direct sunlight and a damp place. Do not store medicine in the bathroom or freezer. Other brands of this drug may have different storage rules.

Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medications down the toilet or down the drain unless instructed to do so. Discard this product when it is expired or no longer used. Consult your pharmacist or local waste disposal company about how to safely dispose of your medicine.

Ketoconazole dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

In what dosage is Ketoconazole available?

Ketoconazole is available in 2 forms, namely oral and topical (topical). For oral use, this drug is generally available in the form of 200 mg tablets.

The dosages listed above are not an exact reference. In most cases, the ketoconazole dose given by the doctor depends on the patient's condition.

If you have a different dose from the one listed above, do not change the dose without a doctor's recommendation and prescription.

What is the ketoconazole dosage for adults?

• Ketoconazole dose for Blastomycosis: 200 mg orally once a day
• Ketoconazole dose for Chromomycosis: 200 mg orally once a day
• Ketoconazole dose for Coccidioidomycosis: 200 mg orally once a day
• Ketoconazole dose for histoplasmosis: 200 mg orally once a day
• Ketoconazole dose for paracoccidioidomycosis: 200 mg orally once a day

What is the ketoconazole dosage for children?

In general, this medicine is not recommended for children who are not yet 2 years old.

The following is the recommended dosage to be given to your child:

• Dosage for children ≥2 years with Blastomycosis: 3.3-6.6 mg / kg orally once a day
• Dosage for children ≥2 years with Chromomycosis: 3.3-6.6 mg / kg orally once a day
• Dosage for children ≥2 years old with Coccidioidomycosis: 3.3-6.6 mg / kg orally once a day
• Dosage for children ≥2 years old with Histoplasmosis: 3.3-6.6 mg / kg orally once a day
• Dosage for children ≥2 years of age with paracoccidioidomycosis: 3.3-6.6 mg / kg orally once a day

Ketoconazole side effects

Side effects due to ketoconazole?

Common side effects of ketoconazole tablets are:

• Mild nausea, vomiting, or stomach pain
• Mild itching or rash
• Headache
• Dizzy
• Swelling of the breast; or
• Impotence or loss of sex drive

Call your doctor if you have serious side effects, such as:

• Dizziness, fainting, fast or pounding heart rate
• Easy bruising or bleeding, weakness is not uncommon
• Numbness or tingling sensation
• Severe depression, confusion, or thoughts of self-harm; or
• Nausea, abdominal pain, low-grade fever, no appetite, weakness, dark urine, putty bowel movements, jaundice (yellowing of the skin or eyes)

You also need to be vigilant because ketoconazole has the potential to trigger serious liver problems (hepatotoxicity). Here are some of the symptoms you need to be aware of:

• Upper abdominal pain
• Loss of appetite
• The color of the urine darkens
• Gray stool

In addition, this drug also has the potential to cause serious allergic reactions, including anaphylaxis. This condition can be life threatening and requires immediate medical attention. Call an ambulance if any of the following symptoms occur:

• Rash on skin
• Itchy rash
• Breathing problems
• Swallowing problems
• Swelling of the hands, face, or mouth

Not everyone experiences the above side effects. There may be some side effects that are not mentioned.

If you have concerns about certain side effects, consult your doctor or pharmacist.

Ketoconazole Drug Warnings and Cautions

What should be known before using this drug?

Before using ketoconazole, do the following tips:

Inform the doctor about the drugs that are being consumed

Tell your doctor and pharmacist if you are allergic to ketoconazole or any other drugs or ingredients found in ketoconazole tablets. Ask your pharmacist or check the Medication Instructions for a list of drug ingredients that might trigger interactions with ketoconazole.

Also, tell your doctor if you are taking alprazolam (Niravam, Xanax); eplerenone (Inspra); ergot alkaloids such as ergotamine (Ergomar, in Cafergot, in Migergot), dihydroergotamine (D.H.E 45, Migranal), and methylergonovine (Methergine); felodipine (Plendil); irinotecan (Camptosar); lovastatin (Mevacor); lurasidone (Latuda); midazolam (Versed); nisoldipine (Sular); simvastatin (Zocor); tolvaptan (Samsca); and triazolam (Halcion).

Your doctor may recommend not using ketoconazole if you are taking this drug.

Also inform your doctor and pharmacist about the prescription and non-prescription drugs, vitamins, nutritional supplements, and herbal products you use. Many drugs also interact with ketoconazole, so be sure to tell your doctor all the drugs you use, even if they are not on this list.

Tell me your health condition or if you are pregnant

Tell your doctor if you are sick or have had any medical conditions.

Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you are planning to become pregnant and are currently taking Ketoconazole, contact your doctor immediately

If you are going to have surgery, such as dental surgery, tell your doctor or dentist that you are using Ketoconazole.

Rules for taking ketoconazole with indigestion drugs (antacids)

If you are taking antacids that contain aluminum, calcium, or magnesium, take them 1 hour before or 2 hours after ketoconazole.

Be careful with alcohol consumption

You should know that consumption of alcohol (including wine, beer, and alcohol-containing drugs such as cough drops) while using ketoconazole increases the risk of developing liver damage.

In addition, unwanted symptoms such as hot and flushed face, rash, nausea, headache, and swelling of the hands, feet, or lower legs can occur if you consume alcohol while using ketoconazole.

Is Ketoconazole safe for pregnant and lactating women?

There is no adequate research on the risks of using ketoconazole in pregnant or breastfeeding women.

Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category C according to the US Food and Drug Administration (FDA).

Drugs that fall into category C, have the following two possibilities:

• Research on the effects of ketoconazole in animals has shown side effects on the fetus.
• However, no study results are strong enough to prove whether this drug affects fetal health.

Ketoconazole can also pass into breast milk so that it may cause side effects in a nursing baby. Before deciding to take this drug while breastfeeding, first consult your doctor.

The following references the pregnancy risk categories according to the FDA:

• A = Not at risk
• B = No risk in several studies
• C = May be risky
• D = There is positive evidence of risk
• X = Contraindicated
• N = Unknown

Ketoconazole Drug Interactions

What medicines might interact with ketoconazole?

Drug interactions can change the performance of drugs or increase the risk of serious side effects. Not all possible drug interactions are listed in this article.

Keep a list of all the products you use (including prescription / non-prescription drugs and herbal products) and consult your doctor or pharmacist. Do not start, stop, or change any dose without your doctor's approval.

Reporting from Healthline, here are some types of drugs that might trigger interactions with ketoconazole:

• Ritonavir and atorvastatin: taking ketoconazole with ritonavir and atorvastatin increases the risk of stronger side effects from ketoconazole.
• Painkillers (buprenorphine, fentanyl, or oxycodone): if these drugs are taken together with ketoconazole has the potential to slow down breathing.
• Anticoagulants (rivaroxaban, dabigatran, or warfarin): blood-thinning drugs in combination with ketoconazole increase the risk of bleeding.
• Heart disease medicine (felodipine or nisoldipine): ketoconazole combined with heart drugs triggers swelling in the arms, legs, and the risk of heart failure.
• Tamsulosin: taking tamsulosin with ketoconazole causes side effects such as dizziness, headache, and low blood pressure.
• Digoxin: the drug digoxin taken with ketoconazole causes headaches, dizziness, and stomach upset.
• Antipsychotic drugs (aripiprazole, buspirone, haloperidol, quetiapine, and risperidone): symptoms such as dizziness, headache, and drowsiness or weakness may occur when ketoconazole interacts with antipsychotic drugs.
• Blood pressure medications (sildenafil, tadanafil, and vardenafil): the possible effects of ketoconazole combined with blood pressure medications are decreased heart rate, low blood pressure, and dizziness.
• Erectile dysfunction drugs (sildenafil, tadalafil, vardenafil): taking ketoconazole with erectile dysfunction medication may cause headaches, stomach pain, and muscle aches.
• Antiviral drugs (indinavir, maraviroc, and saquinavir): if you are on antiviral medication and take this drug at the same time, you may develop stomach pain, nausea, and headaches.

Meanwhile, you should avoid the following drugs because they will reduce the performance of ketoconazole drugs:

• Ranitidine
• Famotidine
• Cimetidine
• Pantoprazole
• Omeprazole
• Rabeprazole
• Aluminum hydroxide
• Antibiotics (isoniazid and rifabutin)
• Anticonvulsants (carbamazepine and phenytoin)
• Antivirus (efavirenz and nevirapine)

Can food or alcohol interact with this drug?

Certain drugs should not be used when eating or consuming certain foods because drug interactions can occur.

Smoking tobacco or consuming alcohol with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

What health conditions can interact with this drug?

The presence of other health problems in your body can affect the use of this drug. Tell your doctor if you have other health problems, in particular:

• History of liver problems
• Adrenal gland problems
• History or family history of long QT syndrome

Ketoconazole overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department.

Here are the symptoms of a ketoconazole overdose that you need to watch out for if it happens to you or those around you:

• Decreased pupil size (dark circle in the middle of the eye)
• Difficulty breathing
• Severe drowsiness
• Unconscious
• Coma (loss of consciousness over a period of time)
• Heart rate slows down
• Weak muscles
• Cool, clammy skin

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.