Ketoconazole, Nizoral

  • See Also
  1. Imidazole
  2. Topical Antifungal
  • Precautions
  1. Hepatotoxicity risk (FDA black box warning)
    1. Oral forumulation indicated only for severe, refractory systemic fungal infections due to Ketoconazole hepatotoxicity
    2. No longer indicated in Skin Infections
    3. If Ketoconazole is used, requires Liver Function Tests at baseline and again weekly
  • Adverse Effects
  • Oral (systemic formulation)
  • Drug Interactions
  • Oral (systemic formulation)
  1. Serious Cardiac Arrhythmia with Hismanal or Seldane (off market in U.S.)
  2. Multiple other Drug Interactions
    1. CYP2C9 Inhibitor
    2. CYP3A3 Inhibitor and CYP3A4 Inhibitor
  • Lab monitoring
  • Oral (systemic formulation)
  1. Follow Liver Function Tests at baseline and weekly
  • Directions
  1. Taking with food decreases gastric irritation