| Download the amazing global Makindo app: Android | Apple | |
|---|---|
| MEDICAL DISCLAIMER: Educational use only. Not for diagnosis or management. See below for full disclaimer. |
Ketoconazole 💊
⚠️ Hepatotoxicity warning: Serious and sometimes fatal liver injury has occurred with oral ketoconazole, even at low doses. Because of this, it should only be considered in the treatment of certain life-threatening systemic mycoses when no safer alternatives are available or tolerated.
📖 About
Synthetic imidazole antifungal. Always check the BNF link here for up-to-date prescribing guidance.
⚙️ Mode of Action
- Inhibits fungal cytochrome P450 enzymes → blocks ergosterol synthesis (disrupts fungal cell membrane).
- Also inhibits human CYP450 steroidogenic enzymes → lowers cortisol and androgens (used off-label in Cushing’s disease – ~50% response rate).
💊 Indications & Dose (specialist use)
- Systemic mycoses (oral use only if no alternative): Blastomycosis, Coccidioidomycosis, Histoplasmosis, Chromomycosis, Paracoccidioidomycosis.
- Topical use: Superficial fungal infections (skin, dandruff, seborrhoeic dermatitis) – generally safe.
🔗 Interactions
- Potent inhibitor of CYP3A4 → major drug–drug interactions (↑ levels of many drugs).
⚠️ Cautions
- Concomitant use with drugs that prolong QT (e.g. dofetilide, quinidine, pimozide, cisapride).
- Monitor LFTs (ALT, AST, bilirubin, ALP), coagulation profile (PT/INR).
🚫 Contraindications
- Should not be used as first-line treatment for any fungal infection.
- History of hepatic disease or previous hepatotoxicity with azoles.
❗ Side Effects
- Hepatotoxicity: ~1 in 15,000 cases can be fatal.
- GI intolerance (nausea, vomiting, abdominal pain).
- QT prolongation → risk of torsades de pointes.
📚 References
- BNF – Ketoconazole
- MHRA Drug Safety Update: Ketoconazole hepatotoxicity risk
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
|
|
Categories
- A Level
- About
- Acute Medicine
- Anaesthetics and Critical Care
- Anatomy
- Anatomy and Physiology
- Biochemistry
- Book
- Cardiology
- Collections
- CompSci
- Crib Sheets
- Crib sheets
- Dental
- Dermatology
- Differentials
- Drugs
- ENT
- Education
- Electrocardiogram
- Embryology
- Emergency Medicine
- Endocrinology
- Ethics
- Foundation Doctors
- GCSE
- Gastroenterology
- General Practice
- Genetics
- Geriatric Medicine
- Guidelines
- Gynaecology
- Haematology
- Hepatology
- Immunology
- Infectious Diseases
- Infographic
- Investigations
- Lists
- Mandatory Training
- Medical Students
- Microbiology
- Nephrology
- Neurology
- Neurosurgery
- Nutrition
- OSCE
- OSCEs
- Obstetrics
- Obstetrics Gynaecology
- Oncology
- Ophthalmology
- Oral Medicine and Dentistry
- Orthopaedics
- Paediatrics
- Palliative
- Pathology
- Pharmacology
- Physiology
- Procedures
- Psychiatry
- Public Health
- Radiology
- Renal
- Respiratory
- Resuscitation
- Revision
- Rheumatology
- Statistics and Research
- Stroke
- Surgery
- Toxicology
- Trauma and Orthopaedics
- USMLE
- Urology
- Vascular Surgery