Sometimes fungal infections in our body are very annoying, aren't they? These can occur on the skin, nails, or even inside the body. So, in times like these, a powerful medicine that a doctor prescribes for you is called Ketoconazole. This is also commonly known by the brand name Nizoral. But there are a few things that we need to be very careful about while using this medicine. Today, we will talk about this medicine from A to Z in a simple way that you can understand.
What is Ketoconazole?
Simply put, ketoconazole is an antifungal medication . This means that it kills harmful fungi that grow in our bodies.
Remember one very important thing. This medicine only works for fungal infections. It will not cure a cold, flu, or other infections caused by bacteria or viruses that you have. Therefore , use this medicine only if a doctor has made an accurate diagnosis and prescribed it.
Things you need to tell your doctor before starting this medication
Before your doctor prescribes this medicine, he or she will need to get a complete picture of your health. Therefore, if you have any of the following conditions, be sure to tell your doctor .
- If you have ever had an allergic reaction to ketoconazole or any other medicine, food, or dye.
- If you are an alcoholic .
- If you have heart disease or heart failure.
- If your heartbeat is irregular or very slow .
- If you have any liver disease .
- If you have abnormalities in the levels of electrolytes , such as magnesium or potassium, in your blood.
- If your adrenal glands are underactive.
- If you are pregnant or expecting a baby soon.
- If you are a breastfeeding mother .
It is very important for your safety to talk to the doctor without hiding this information.
What is the best way to take the medicine?
As the doctor says, it is very important to take the correct dosage at the correct time.
- Take this pill with a glass of water.
- Try to take the medicine at the same time every day.
- This medicine is best absorbed and works when taken with a meal .
- Do not stop taking the medicine halfway just because your symptoms have subsided. You must complete the course , which is the number of days prescribed by your doctor. Failure to do so may result in the infection returning.
- If you are taking antacids or other stomach acid-reducing medications (PPIs) for conditions like gastritis, do not take them at the same time as ketoconazole. Take them one hour before or two hours after taking the ketoconazole pill.
What if I miss a dose? (Missed Dose)
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose to make up for a forgotten dose.
What to do if you take too much medicine? (Overdose)
If you think you have taken too much medicine, don't delay. Go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
Attention! Other drugs that may interact with this medicine (Drug Interactions)
This is the most important part of this article. Ketoconazole is a drug that can interact with many other drugs. These interactions can sometimes be very dangerous. Therefore, it is essential to tell your doctor about all the medications you are taking (prescribed by other doctors, bought from the pharmacy, vitamins, herbal medicines, traditional medicines).
The two tables below list the main drugs that may interact with ketoconazole.
| Dangerous! Never take these with ketoconazole! | |
|---|---|
| Drug category | Examples |
| Some cholesterol-lowering medications | Lovastatin, Simvastatin, Cerivastatin |
| Some medications for irregular heartbeat | Disopyramide, Dofetilide, Dronedarone, Quinidine |
| Some medications for depression or sleep | Alprazolam, Midazolam, Triazolam |
| Some medications for migraines (Ergot class) | Ergotamine, Dihydroergotamine |
| Other medications | Cisapride, Colchicine, Methadone, Pimozide, Ranolazine, Sirolimus, Tolvaptan, Lurasidone |
| Be careful! These can cause reactions - medical advice is essential | |
|---|---|
| Drug category | Examples |
| Alcohol or alcohol-containing products | - |
| Some blood pressure medications | Amlodipine, Nifedipine, Verapamil |
| Medicines for HIV/AIDS | (Ask the doctor) |
| Some medications for cancer | Dasatinib, Imatinib, Docetaxel |
| Some medications for seizures | Carbamazepine, Phenytoin |
| Anticoagulant | Warfarin, Rivaroxaban |
| Medicines for male sexual dysfunction | Sildenafil, Tadalafil |
| Steroid drugs | Dexamethasone, Methylprednisolone |
| Some medicines given for tuberculosis | Rifampin, Isoniazid |
This list is not complete. There may be other medications. Therefore, it is best to inform your doctor about all medications you are taking.
Side effects that may occur while taking the medicine
Like any medication, ketoconazole can cause side effects. Some are not serious, but some we should be very careful about.
| Type of side effect | Description and what to do |
|---|---|
| Serious side effects that should be reported to your doctor immediately | |
| Allergic Reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Symptoms of Liver Injury | Pain in the upper right side of the abdomen, loss of appetite, nausea, yellowing of the skin or eyes , dark yellow/brown urine, and unusual fatigue. These are very dangerous symptoms. |
| Changes in heart rate | Fast or irregular heartbeat, dizziness, feeling faint, chest pain, difficulty breathing. |
| Decreased adrenal function | Nausea, vomiting, loss of appetite, unusual tiredness, dizziness. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Stomach ache | This can be reduced by taking the medicine with food. |
| Nausea | - |
| Headache | - |
| Diarrhea | - |
How to store and dispose of medicine safely?
- Keep medicine out of the reach of children and pets .
- Store at room temperature (between 20-25 degrees Celsius), protected from moisture and direct sunlight, and tightly closed in an airtight container.
- The best way to dispose of expired or unwanted medications is to drop them off at a hospital or pharmacy's "take-back program." If that's not possible, remove the pills from the container, mix them with something like coffee grounds, soil, or used cat litter, put them in a bag or other container, seal it tightly, and throw them in the trash. Ask your doctor for more advice.
Take-Home Message
- Ketoconazole is a powerful medication used exclusively for fungal infections.
- Before starting this medication, it is imperative to tell your doctor about all your medical conditions and all other medications you are taking.
- Do not start any new medication without medical advice, due to possible dangerous interactions with other medications.
- If you notice signs of liver damage, such as yellowing of the eyes or skin, dark urine, or pain on the right side of the stomach, see a doctor immediately.
- Finish the full course of medication prescribed by your doctor. Stopping the medication just because your symptoms have subsided may cause the infection to return.
- This is a medicine prescribed for you only. Never share it with others.
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