Drug Notebook

FDA Alerts

  • Oral ketoconazole has been associated with hepatoxicity, including some fatalities. Inform patients of the risk and monitor closely.
  • Concomitant use with cisapride or with astemizole or terfenadine (drugs no longer commercially available in the US) is contraindicated. Pharmacokinetic interactions can occur and serious cardiovascular events have been reported with concomitant use. VT, VF, and torsades de pointes have been reported in patients receiving concomitant cisapride; death, VT, and torsades de pointes have been reported in patients receiving concomitant terfenadine. (See Interactions.)

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ketoconazole
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(KEE toe KON a zole)

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.

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.

What should I discuss with my healthcare provider before taking 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 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.
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