Ketoconazole
- Atc Codes:D01AC08#G01AF11#J02AB02
- CAS Codes:65277-42-1
- PHARMGKB ID:65277-42-1
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Fungoral, Ketoconazol, Nizoral; Belgium: Nizoral; Bulgaria: Ketoconazole, Ketozal, Nizoral; Cyprus: Ilgem, Ketozal, Ketrozol, Nizoral, Tinuvin, Vafluson; Czech Republic: Asquam, Nizoral; Denmark: Ketoconazole, Nizoral; Estonia: Altis, Ketoconazol, Mikanisal, Nizoral, Oronazol, Senosal; Finland: Ketoconazol, Konact, Nizoral; France: Ketoconazole, Ketoderm, Nizoral; Germany: Fungoral, Ketoconazol, Nizoral, Terzolin; Greece: Abba, Adenosan, Aquarius, Botaderm, Ebersept, Flidaphen, Fungoral, Ilgem, Ketoconazole, Libroman, Mycofebrin, Neo-Egmol, Nyoxep, Reprol, Sostatin; Hungary: Ketospor, Korfa, Nizoral; Ireland: Ketopine, Ketozol, Nizoral; Italy: Asquam, Ketoconazolo, Nizoral, Triatop; Latvia: Fungoral, Ketoconazol, Mikanisal, Nizoral; Lithuania: Altis, Ketoconazol, Nizoral; Luxembourg: Nizoral; Malta: Nizoral, Dermatin Shampoo; Netherlands: Asquam, Ketoconazol, Nizoral; Poland: Apo-Keto SR, Fungores, Ketokonazol, Nizoral, Noell, Zoxinat; Portugal: Cetoconazol, Farmorol, Nizale, Nizoral, Tedol; Romania: Kefungin, Keto-Tis, Ketoconazol, Ketostin, Nizoral; Slovakia: Nizoral; Slovenia: Oronazol; Spain: Fungarest, Fungo, Keto-cure, Ketoconazol, Ketoisdin, Medezol, Panfungol; Sweden: Fundan, Fungoral, Ketoconazol, Ketoson, Kezol; UK: Daktarin Gold, Daktarin Intensive, Ketoconazole, Nizoral.
North America
Canada: Ketoconazole, Ketoderm, Nizoral, Nu-Ketocon; USA: Extina, Ketoconazole, Ketozole, Nizoral, Xolegel.
Latin America
Argentina: Eumicel, Faction, Fangan, Fitonal, Grenfung, Keduo, Ketoconazol, Ketolef, Ketonazol, Micoral, Orifungal, Perative, Pitylis, Quadion, Sinamida Accion Caspa, Socosep, Tikl; Brazil: Aciderm-Cetoconazol, Arcolan, Candiderm, Candoral, Capel, Cetoconalab, Cetoconazol, Cetoderm, Cetomed, Cetomizol, Cetonax, Cetoneo, Cetonil, Cetonin, Dermitrat, Ketonazol, Lozan, Miconan, Micoral, Nizoral, Nizoretic, Noriderm, Noronal, Zanoc, Zolmicol; Mexico: Akorazol, Biozoral, Conazol, Cremosan, Ergomicon, Eurolat, Fungipar, Fungoral, Hispazzon, Honzil, Ketoconazol, Ketofar, Ketomed, Ketomizol, Ketoril, Konaderm, Konaturil, Lizovag, Messelzol, Micoser, MI-KE-SON’S-V, Mycocil, Mycodib, Nastil, Nazolfarm, Nazoltec, Nizoral, Onofin-K, Prenalon, Remecon, Strizole, Termizol, Tiniasil, Tiniazol, Toconal, Tolcrem, Tomiko, Triatop.
Asia
Japan: Ketopamin, Nitrazen, Nizoral, Pulna.
Drug combinations
Ketoconazole and Clindamycin
Ketoconazole and Cyproheptadine
Ketoconazole, Gentamicin, and Hydrocortisone
Ketoconazole, Dexamethasone, Gentamicin, and Hydrocortisone
Other Ketoconazole combinations: Dexpanthenol
Chemistry
Ketoconazole: C~26~H~28~Cl~2~N~4~O~4~. Mw: 531.43. (1) Piperazine, 1-acetyl-4-[4-[[2-(2,4-dichlorophenyl)-2-(1H-imidazol-1-ylmethyl)-1,3-dioxolan-4-yl]methoxy]phenyl]-, cis-; (2)(±)-cis-1-Acetyl-4-[p-[[2-(2,4-dichlorophenyl)-2-(imidazol-1-ylmethyl)-1,3-dioxolan-4-yl]methoxy]phenyl]piperazine. CAS-65277-42-1 (1978).
Pharmacologic Category
Anti-infective Agents; Antifungals; Azoles. Skin and Mucous Membrane Agents; Antifungals; Azoles. (ATC-Code: D01AC08; G01AF11; J02AB02).
Mechanism of action
Alters permeability of cell wall by blocking fungal cytochrome P450. Inhibits biosynthesis of triglycerides and phospholipids by fungi. Inhibits several fungal enzymes, which results in build-up of toxic concentrations of hydrogen peroxide. Also inhibits androgen synthesis.
Therapeutic use
Treatment of susceptible fungal infections, including candidiasis, oral thrush, blastomycosis, histoplasmosis, paracoccidioidomycosis, coccidioidomycosis, chromomycosis, candiduria, chronic mucocutaneous candidiasis, as well as certain recalcitrant cutaneous dermatophytoses. Treatment of Tinea corporis, T. cruris, T. versicolor, cutaneous candidiasis, seborrheic dermatitis, dandruff.
Pregnancy and lactiation implications
Teratogenic effects noted in animal studies. There are no adequate, well-controlled studies in pregnant women. Enters breast milk (use not recommended during lactation).
Unlabeled use
Treatment of prostate cancer (androgen synthesis inhibitor).
Contraindications
Hypersensitivity to ketoconazole or any component of the formulation. CNS fungal infections (due to poor CNS penetration). Co-administration with ergot derivatives or cisapride contraindicated (risk of potentially fatal cardiac arrhythmias).
Warnings and precautions
Possible adrenal suppression (with high doses of ketoconazole). Ketoconazole associated with hepatotoxicity (use with caution in pre-existing hepatic impairment). Concomitant use with cisapride contraindicated (risk of ventricular arrhythmias). Some formulations may contain alcohol and propane/butane, or sulfites.