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Ketoconazole is classified in a family of medicines known as imidazoles. It is a custom pharmacy drug that is widely prescribed for the treatment of fungal infections. Ketoconazole is sometimes used to treat tinea cruris (jock itch), tinea corporis (ringworm), tinea versicolor (an infection that produces discoloration of the skin), and tinea pedis (athlete's foot). Additionally it is used as an ingredient in some dandruff shampoos to control the itching, flaking, and irritation that typically come with the condition, and for treatment of seborrheic dermatitis as well. As ketoconazole can cause liver damage in some patients, it is only to be used when other antifungal medications are not an option. Ask your physician about the risks of using ketoconazole.


As a topical cream, ketoconazole is usually applied once daily for up to six weeks, or as directed by your physician. Prescription grade shampoo is used once for treatment only. Over-the-counter shampoos are used regularly, approximately every three days, for up to eight weeks, then only as needed, as per your physician's recommendations. Use extreme caution to not allow any ketoconazole into your eyes or mouth.

Your physician may prescribe an oral tablet for some fungal infections. Follow your physician's directions carefully regarding dosage.


Side effects may present while using this drug. If you encounter any side effects that are lingering or getting worse, contact your doctor right away. Lists of some common and severe side effects seen with ketoconazole are provided below. If you experience any severe side effects, get medical treatment immediately.

Common Side Effects (Topical Ketoconazole):

  • Oily Hair
  • Dry Hair
  • Dry Scalp
  • Irritation, Stinging, or Itching at Site of Application
  • Hair Texture Changes
  • Scalp Blisters
  • Dry Skin
  • Itching

Severe Side Effects (Topical Ketoconazole):

  • Redness, Swelling or Pain at Site of Application
  • Tenderness at Site of Application
  • Trouble Breathing
  • Trouble Swallowing
  • Rash and/or Hives

Common Side Effects (Oral Ketoconazole):

  • Change in Sperm Count
  • Decreased Interest in Sex
  • Unable to Achieve Erection
  • Breast Swelling
  • Feeling Sleepy
  • Diarrhea
  • Hair Loss

Severe Side Effects (Oral Ketoconazole):

  • Stomach Pains
  • Stiffness and/or Swelling
  • Mental Changes
  • Nausea and/or Vomiting
  • Nosebleeds
  • Painful Urination
  • Paleness of Skin
  • Low Appetite
  • Red Spots on Skin
  • Puffiness of Eyelids
  • Back Pain
  • Leg Pain
  • Tarry Stools
  • Bleeding Gums
  • Confusion
  • Body Swelling
  • Blood in Urine
  • Blood in Stool
  • Pale or Light-Colored Stools
  • Blurry Vision
  • Numbness or Tingling Feeling
  • Change in Ability to View Colors
  • Chest Pain
  • Dark Urine
  • Puffy Around Eyes, Face, Lips, or Tongue
  • Redness
  • Skin Rash,
  • Hives or Itching
  • Sore Throat or Cough
  • White Spots on Lips / in Mouth
  • Mouth Sores
  • Swelling of Eyes
  • Swollen Glands
  • Difficulty with Night Vision
  • Trouble Swallowing
  • Dizziness
  • Accelerated Heartbeat
  • Fever
  • Headaches
  • Tightness in Chest
  • Trouble Sleeping
  • Trouble Breathing
  • Difficulty Swallowing
  • Unusual Bleeding
  • Abnormal Bruising
  • Unusual Tiredness
  • Jaundice
  • Hoarseness
  • Increased Sensitivity to Light
  • Irritation
  • Joint Pain


Do not use ketoconazole unless you have consulted with your physician and he or she has cleared you for use of this drug.

Ask your doctor about contraindications, as there are possibly many.

Ketoconazole is contraindicated for the following:

  • Decreased Function of Adrenal Gland
  • Rapid Heartbeat
  • EKG: Prolonged QT interval
  • Abnormal EKG
  • Absence of Stomach Acid
  • Hepatitis (drug-caused)
  • Abnormal Liver Function and/or Tests
  • "It is rare to find health professionals who are so willing to educate the patient on what they need to know."

    Clair C. | West Hollywood, CA