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DERMATOLOGICALS › ANTIFUNGALS FOR DERMATOLOGICAL USE › ANTIFUNGALS FOR TOPICAL USE › Imidazole and triazole derivatives
ketoconazole
D01AC08
Adult Dosing
- Tinea corporis, tinea cruris, tinea pedis: Apply 2% cream to affected and immediate surrounding area once daily for 2 weeks
- Cutaneous candidiasis, tinea versicolor: Apply 2% cream once daily for 2 weeks
- Seborrheic dermatitis: Apply 2% cream twice daily for 4 weeks or until clinical clearing
- Dandruff / Seborrheic dermatitis (scalp): Apply 2% shampoo twice weekly for 4 weeks with at least 3 days between applications
Pediatric Dosing
- Safety and efficacy of topical cream not established in pediatric patients
- Shampoo use in children under 12 years: Safety and efficacy not established
Indications
- Treatment of tinea corporis, tinea cruris, and tinea pedis caused by Trichophyton rubrum, T. mentagrophytes, and Epidermophyton floccosum
- Treatment of tinea versicolor (Pityriasis versicolor)
- Treatment of cutaneous candidiasis
- Treatment of seborrheic dermatitis
- Topical shampoo for reduction of dandruff
Mechanism of Action
- Inits fungal cytochrome P450 14-alpha-demethylase, impairing ergosterol synthesis
- Increases fungal cell membrane permeability and inhibits fungal growth
Contraindications
- Hypersensitivity to ketoconazole or any component of the formulation
- Prior history of drug-induced liver injury from oral ketoconazole (not strictly a contraindication for topical, but use with caution)
Adverse Reactions
- Application site burning
- Pruritus
- Erythema
- Contact dermatitis
- Dry skin (from shampoo)
- Hair discoloration or abnormal hair texture (rare, from shampoo)
Drug Interactions
- Topical absorption is minimal, making systemic drug interactions unlikely
- Concurrent use of topical corticosteroids on the same skin site may lead to local irritation or delayed treatment response
Curated Content: Needs Vetting Before Put to Clinical Use