Ketoconazole

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What is the most important information I should know about ketoconazole?

You should not use this medication if you are allergic to ketoconazole, or if you are also taking cisapride (Propulsid) or triazolam (Halcion). Other drugs that should not be taken together with ketoconazole include astemizole (Hismanal) and terfenadine (Seldane) (these drugs are no longer available in the U.S.).

Before taking ketoconazole, tell your doctor if you have liver disease, kidney disease, a heart rhythm disorder, decreased stomach acid (achlorhydria), or a history of "Long QT syndrome.”

Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Ketoconazole will not treat a viral infection such as the common cold or flu.

Avoid taking antacids or stomach acid reducers (Tagamet, Pepcid, Axid, Zantac, and others) for at least 2 hours after you have taken your dose of ketoconazole. These medications can make it harder for the ketoconazole tablet to dissolve in your stomach.

Avoid drinking alcohol. It may cause unpleasant side effects while you are taking ketoconazole.

Warning

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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What is ketoconazole?

Ketoconazole is an antifungal antibiotic.

Ketoconazole is used to treat infections caused by fungus, which can invade any part of the body including the mouth, throat, esophagus, lungs, bladder, or skin.

Ketoconazole may also be used for other purposes not listed in this medication guide.

Precautions

Before taking ketoconazole, tell your doctor if you are allergic to any drugs, or if you have:

decreased stomach acid (achlorhydria);
liver disease;
kidney disease;
a heart rhythm disorder; or
a personal or family history of "Long QT syndrome."

If you have any of these conditions, you may need a dose adjustment or special tests to safely take ketoconazole.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Ketoconazole may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Avoid drinking alcohol. It may cause unpleasant side effects while you are taking ketoconazole.

Instructions

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a ketoconazole overdose are not known.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

dizziness, fainting, fast or pounding heartbeat;
easy bruising or bleeding, unusual weakness;
numbness or tingly feeling;
severe depression, confusion, or thoughts of hurting yourself; or
nausea, stomach pain, low fever, loss of appetite, weakness, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

mild nausea, vomiting, or stomach pain;
mild itching or skin rash;
headache;
dizziness;
breast swelling; or
impotence or loss of interest in sex.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Interactions

Many drugs can interact with ketoconazole. Below is just a partial list. Tell your doctor if you are using:

acetaminophen (Tylenol);
cyclosporine (Gengraf, Sandimmune, Neoral);
digoxin (digitalis, Lanoxin);
tacrolimus ((Prograf);
loratadine (Alavert, Claritin, Tavist ND);
methylprednisolone (Medrol);
phenytoin (Dilantin);
rifampin (Rifadin, Rifater, Rifamate, Rimactane);
diabetes medication you take by mouth;
a sedative such as midazolam (Versed);
a blood thinner such as warfarin (Coumadin);
cancer medications;
birth control pills or hormone replacement therapy;
methotrexate (Rheumatrex, Trexall);
cholesterol medications such as niacin (Advicor), atorvastatin (Lipitor), lovastatin (Altocor, Mevacor), simvastatin (Zocor), and others; or
medications to treat HIV or AIDS.

This list is not complete and there are many other drugs that can interact with ketoconazole. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.