Nizoral

1 What is Nizoral?

Brand: Nizoral

Generic: Ketoconazole

Nizoral is an antifungal medication used to treat fungal infections.

Doctors prescribe Nizoral to treat fungal diseases such as:

  • blastomycosis
  • histoplasmosis
  • paracoccidioidomycosis
  • coccidioidomycosis
  • chromomycosis

Nizoral is a preferred agent to treat patients with fungal infections cases that have resisted or cannot use other antifungal drugs.

Nizoral belongs to the azole class of antifungals. It works by causing problems to the formation of tough membrane enveloping the cell of the fungi, causing cell death.

Nizoral is not a first-line drug for treating fungal infections. Doctors choose Ketoconazole for fungal infection cases where no other antifungal medications are feasible or available, and the potential benefits outweigh risks of treatment. Nizoral requires a prescription.

Nizoral is not appropriate for treating Cushing syndrome and prostate cancer. Ketoconazole does not work for infections caused by bacteria and viruses.

Nizoral can cause serious liver problems, some of which require a liver transplant. This can happen to patients with or without history or diagnosed liver issues. Ketoconazole may also cause heart problems that can be fatal, especially if you take certain medicines. Use Ketoconazole cautiously and always follow doctor’s instructions during treatment.

2 What to Know Before Using

If you are about to start Nizoral, speak with your doctor about what you need to know. If you experienced allergies to Nizoral (including shampoos and lotion products with Ketoconazole), tell it to your doctor right away. You cannot use Nizoral if you are allergic to it.

Tell your doctor if you have liver problems before receiving Ketoconazole. Ketoconazole is highly contraindicated in patients with liver disease.

Tell the doctor if you are pregnant or breastfeeding before receiving Ketoconazole. Ketoconazole is an FDA pregnancy category C drug, which means it may cause problems to the unborn babies when given to pregnant patients. Do not breastfeed when receiving Ketoconazole because it can be expressed in breast milk.

Do not consume alcohol when receiving Ketoconazole.

The safety and effectiveness of Ketoconazole in children and patients less than 18 years of age is not fully understood.

Tell the doctor all the medicines you take before receiving Ketoconazole.

Tell the doctor if you take the following medications:

  • Afatinib
  • Ado-Trastuzumab Emtansine
  • Alfuzosin
  • Aliskiren
  • Alitretinoin
  • Almotriptan
  • Alosetron
  • Amodiaquine
  • Amphotericin B
  • Antacid medications
  • Antihepaciviral Combination Products
  • Apixaban
  • Aprepitant
  • Aripiprazole
  • Artesunate
  • Astemizole
  • Asunaprevir
  • Atorvastatin
  • Avanafanil
  • Axitinib
  • Barnidipine
  • Bedaquiline
  • Blonanserin
  • Boceprevir
  • Bortezomib
  • Bosentan
  • Bosutinib
  • Brentuximab Vedotin
  • Brexpiprazole
  • Brinzolamide
  • Bromocriptine
  • Budesonide, all forms
  • Buspirone
  • Busulfan
  • Cabazitaxel
  • Cabozantinib
  • Calcium channel blocker
  • Cannabis
  • Carbocisteine
  • Cariprazine
  • Carvedilol
  • Ceritinib
  • Choline C11
  • Cilostazol
  • Cisapride
  • Citaprolam
  • Clopidogrel
  • Clozapine
  • Cobicistat
  • Cobimetinib
  • Codeine
  • Colchicine
  • Conivaptan
  • Corticosteroids, all forms
  • Crizotinib
  • Cyclosporine
  • CYP2A6 Inhibitors
  • CYP2C19 Inhibitors
  • CYP2C9 Inhibitors
  • CYP2D6 Inhibitors
  • CYP3A4 Inducers
  • CYP3A4 Inhibitors
  • Dabigatran Etexilate
  • Dabrafenib
  • Daclatasvir
  • Dapoxetine
  • Darunavir
  • Dasatinib
  • Dasatinib
  • Didanosine
  • Dienogest
  • Dihydroergotamine
  • Disopyramide
  • Docetaxel
  • Dofetilide
  • Domperidone
  • Doxorubicin
  • Dronabinol
  • Drospirenone
  • Dutasteride
  • Edoxaban
  • Eliglustat
  • Elvitegravir
  • Enzalutamide
  • Erlotinib
  • Eszopiclone
  • Etizolam
  • Etravirine
  • Everolimus
  • Felodipine
  • Fentanyl
  • Fesoterodine
  • Fexofenadine
  • Fimasartan
  • Fingolimod
  • Fluticasone
  • Flibanserin
  • Fosamprenavir
  • Fosphenytoin
  • Gefitinib
  • Grazoprevir
  • Guanfacine
  • H2 antagonist drugs such as Cimetidine, Ranitidine, Famotidine, and Nizatidine
  • Halofrantine
  • Hydrocodone
  • Ibrutinib
  • Idelalisib
  • Ifosfamide
  • Iloperidone
  • Imatinib
  • Indinavir
  • Imidafenacin
  • Indium 111 Capromab Pendetide
  • Isoniazid
  • Ivacaftor
  • Ixabepilone
  • Lacosamide
  • Levobupivacaine
  • Levomilnacipran
  • Lopinavir
  • Losartan
  • Maraviroc
  • Medroxyprogesterone
  • Methylprednisolone
  • Metoprolol
  • Mifepristone
  • Mirodenafil
  • Mirabegron
  • Mitotane
  • Nebivolol
  • Nintedanib
  • Ospemifene
  • Oxybutynin
  • Oxycodone
  • Panobinostat
  • Parecoxib
  • Paricalcitol
  • Perhexiline
  • P-glycoprotein/ABCB1 Inhibitors
  • Phenytoin
  • Pimavanserin
  • Pimecrolimus
  • Ponatinib
  • Pranlukast
  • Prasugrel
  • Praziquantel
  • Prednisolone
  • Prednisone
  • Propafenone
  • Proton pumps inhibitor drugs such as Esomeprazole, Lansoprazole, and Omeprazole
  • Prucalopride
  • Quetiapine
  • Ramelteon
  • Reboxetine
  • Red yeast rice
  • Repaglinide
  • Retapamulin
  • Rifamycin derivatives
  • Rilpivirine
  • Riociguat
  • Rifaximin
  • Ritonavir
  • Romidepsin
  • Ruxolitinib
  • Saquinavir
  • Saxagliptin
  • Sildenafil
  • Siltuximab
  • Sirolimus
  • Solifenacin
  • Sorafenib
  • St. John’s wort
  • Sucralfate
  • Sunitinib
  • Tacrolimus
  • Tadalafil
  • Tamoxifen
  • Tasimelteon
  • Telaprevir
  • Temsirolimus
  • Tipranavir
  • Tizanidine
  • Tocilizumab
  • Tolterodine
  • Tramadol
  • Vardenafil
  • Venetoclax
  • Vilazodone
  • Vincristine
  • Vindesine
  • Vinorelbine
  • Vitamin K Antagonists like Warfarin
  • Zopiclone
  • Zuclopenthixol

You cannot receive Nizoral if you are taking the following medicines:

  • Alprazolam
  • Cisapride
  • Disopyramide
  • Dofetilide
  • Dronedarone
  • Eplenarone
  • Efavirenz
  • Elbasvir
  • Eletriptan
  • Ergot alkaloids such as Dihydroergotamine and Ergotamine
  • Estazolam
  • Ergoloid Mesylates
  • Felodipine
  • Irinotecan
  • Ivabradine
  • Isavuconazonium Sulfate
  • Lovastatin
  • Lumacaftor
  • Lomitapide
  • Lapatinib
  • Lercanidipine
  • Quinidine
  • Lurasidone
  • Methadone
  • Olaparib
  • Osimertinib
  • Macitentan
  • Nisoldipine
  • Naloxegol
  • Nevirapine
  • Nilotinib
  • Nimodipine
  • Midazolam
  • Methylergonovine
  • Pimozide
  • Palbociclib
  • Pimozide
  • Pazopanib
  • Ranolazine
  • Regorafenib
  • Simvastatin
  • Rivaroxaban
  • Tolvaptan
  • Triazolam
  • Tamsulosin
  • Tolvaptan
  • Topotecan
  • Toremifene
  • Trabectedin
  • Saccharomyces boulardii
  • Salmeterol
  • Silodosin
  • Simeprevir
  • Sonidegib
  • Suvorexant
  • Tegafur
  • Telithromycin
  • Terfenadine
  • Thioridazine
  • Ulipristal
  • Vorapaxar
  • Vemurafenib
  • Colchicine and you have problems with the liver or kidneys
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3 Proper Usage

To use Nizoral properly, you must follow all instructions given by your doctor. Nizoral comes with an extra information leaflet. Make sure to understand the information in the included leaflet before taking Nizoral. If you have questions about Nizoral, ask your doctor or pharmacist.

The doctor determines the dose of Ketoconazole you will take every day. Ketoconazole is usually taken once a day. For best results, take Ketoconazole at the same time every day. Ketoconazole is used until fungal infection is resolved, which can take up to 6 months.

You can take Ketoconazole with or without food. If you are also taking antacids, H2 blocker drugs like Famotidine, or proton pump inhibitors such as Omeprazole, you need to take Ketoconazole with an acidic drink like regular sodas.

If you are taking aluminum hydroxide, take it 1 hour before or 2 hours after taking Ketoconazole. Always use Ketoconazole as prescribed by the doctor.

If you missed a dose of Ketoconazole, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and return to original dosing. Do not take two doses of Ketoconazole at once to make up for the missed dose.

You could suffer from overdose if you took too much Ketoconazole than what is prescribed. If this happens, call local poison control hotlines and head to the nearest hospital immediately.

Store Ketoconazole tablets at room temperature away from heat, moisture, and light.

4 Precautions to Take

In using Nizoral, you must be careful and take some precautions as advised by your doctor. Always finish the full course of treatment with Nizoral, even if you are feeling better. Stopping use for even a short while can allow fungi to become resistant to Nizoral and become harder to treat.

Ketoconazole can cause dizziness or drowsiness, which can prove dangerous if you drive or perform unsafe tasks. Taking Ketoconazole with alcohol can enhance these effects. Do not perform these activities right after taking Ketoconazole.

In rare cases, Ketoconazole has caused severe allergic reactions at first dose. If this happens, call your doctor at once.

Alcohol can increase the risk of side effects of Ketoconazole, so avoid consuming alcohol during treatment.

If you receive care from another doctor, a dentist or from emergency services, tell him or her you are taking Ketoconazole.

Ketoconazole may reduce testosterone levels in the body, which can cause loss of interest in sex, low sperm and enlarged breasts in men. Discuss this effect with your doctor. Usually, testosterone levels return back to normal after Ketoconazole is stopped.

Ketoconazole may lower blood sugar levels. Patients with diabetes may need to adjust their medications when receiving Ketoconazole. Diabetics must watch their blood sugar levels closely when taking Ketoconazole.

Note that Ketoconazole may make birth control pills less effective. You must use another form of birth control to prevent pregnancy, like condoms, when having sex.

Ketoconazole can alter lab tests results. Make sure health providers know you are taking Ketoconazole. If you became pregnant or breastfeed while receiving Ketoconazole, call your doctor right away.

5 Potential Side Effects

Nizoral may cause the following serious side effects that require medical attention:

  • Severe allergic reaction symptoms such as:
    • difficulty breathing,
    • skin rash,
    • itching,
    • hives,
    • swelling of the mouth, nose, throat or tongue
  • Liver problem symptoms such as:
    • severe tiredness,
    • jaundice,
    • dark urine,
    • clay-colored stools,
    • loss of appetite,
    • stomach pain,
    • vomiting and severe nausea
  • Bloating
  • Numbness, tingling or burning sensation
  • Chest pain
  • Depression
  • Dizziness, lightheadedness or fainting
  • Fast or irregular heartbeat
  • Fever
  • Chills
  • A persistent sore throat
  • Swelling of the hands, ankles or feet
  • Swollen or tender abdomen
  • Thoughts of self-harm or suicide
  • Unusual bleeding or bruising
  • Vision changes
  • Severe fatigue

Nizoral may cause minor side effects such as:

  • Diarrhea
  • Headache
  • Mild stomach discomfort
  • Nausea
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