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Medical and Pharmacy Editor:

Brand Name: Nizoral

Generic Name: ketoconazole

Drug Class: Antifungals

What Is Ketoconazole and How Does It Work?

Ketoconazole is used to treat certain serious fungal infections in the body. Ketoconazole belongs to the class of drugs called azole antifungals. It works by stopping the growth of the fungus.

Ketoconazole should not be used to treat fungal infections on the skin and nails due to the risk of serious side effects and drug interactions. Talk to your doctor about other medications you can use to treat these types of infection.

Ketoconazole is available under the following different brand names: Nizoral.

Dosages of Ketoconazole:

Adult and Pediatric Dosage Forms and Strengths


  • 200 mg

Dosage Considerations – Should be Given as Follows:

Fungal Infections

Indicated for the treatment of the following systemic fungal infections in patients who have failed or who are intolerant to other therapies: blastomycosis, coccidioidomycosis, histoplasmosis, chromomycosis, and paracoccidioidomycosis

  • Adult: 200-400 mg/day orally
  • Children under 2 years old: Safety and efficacy not established
  • Children 2 years old and older: 3.3-6.6 mg/kg/day orally

Dosage Modifications

Renal impairment: No dosage modifications provided in manufacturer's labeling

Hepatic impairment

  • No dosage modifications provided in manufacturer's labeling
  • If hepatotoxicity occurs during treatment (ALT levels above UNL or ALT 30% above baseline): Interrupt dosing and order a full set of liver tests

Cushing Syndrome (Off-label)

Used off-label to inhibit steroidogenesis in patients with Cushing syndrome

  • 600-800 mg/day orally

Used rarely and often toxic at doses required to reduce cortisol secretion

Recurrent Tinea Versicolor (Off-label)

  • 400 mg orally monthly

Dosing Considerations

Do not use tablets as first-line treatment; should be used only when other effective antifungal therapy is not available or tolerated and the potential benefits are considered to outweigh the potential of hepatotoxicity

Avoid prescribing tablets to treat skin and nail fungal infections owing to risk of serious liver damage, adrenal gland problems, and harmful interactions with other medicines that outweigh its benefit in treating these conditions, which are not approved uses of the drug (these indications were removed from labeling by the FDA in 2013)

Do not use for fungal meningitis because of poor penetration into the cerebrospinal fluid (CSF)

Medically Reviewed by a Doctor on 4/24/2017

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