Ketoconazole

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Oct 13, 2022

Warnings

Ketoconazole Warnings, Risks, and Complications

Both topical and oral ketoconazole can cause serious medical problems in some people. Talk to your doctor about other treatments for a fungal infection if you are at a high risk of complications from this medicine. Some of the risks of ketoconazole use include:

ALLERGIC REACTIONS: A small number of people can develop severe allergic reactions to ketoconazole, including life-threatening anaphylaxis (throat closing). This is a medical emergency. Call 911 if you develop a skin rash, hives, swelling of the tongue or lips, or difficulty breathing or swallowing after using or taking ketoconazole. Before using the cream, tell your healthcare provider if you are allergic to sulfites.
SKIN IRRITATION: Application of ketoconazole gel can cause irritation of the skin in the treated area. Call your healthcare professional if you develop irritation or if your fungal skin infection symptoms get worse while using ketoconazole. Ketoconazole foam can cause an allergic rash, especially after exposure to sunlight. Avoid sun exposure or cover the areas where you apply the foam. Call your doctor if you develop signs and symptoms such as a rash, hives, or swelling.
TOXICITY: Topical formulations of ketoconazole are only meant for external use on the skin and scalp. Swallowing these medications can be harmful. Store ketoconazole safely out of reach of children and pets to prevent accidents. Call your doctor or your local poison control center immediately if someone swallows ketoconazole.
FLAMMABLE PRODUCTS: Ketoconazole gel (Xolegel) and ketoconazole foam (Extina) contain flammable ingredients. Keep these products away from open flames, fires, or heat sources. Do not smoke immediately after using them. Do not discard empty containers into a fire.

Precautions Before Starting Ketoconazole

Tell your doctor if you have had an allergic reaction to ketoconazole, any of the active or inactive ingredients in ketoconazole topical products, or any other medicated creams, shampoos, gels, or foams. Your pharmacy can give you a list of ingredients.

Give your doctor a complete medical history. Ketoconazole may not be right for people with a specific medical condition. Before using ketoconazole cream, tell your doctor if you have asthma.

Give your doctor or pharmacist a complete list of your medications, including prescription medications, non-prescription medicines, vitamins, supplements, and herbal products. This can help avoid possible interactions between ketoconazole and your other medicines.

Tell your doctor if you are pregnant, could be pregnant, planning a pregnancy, or are breastfeeding.

You should know that ketoconazole can remove the curl from permanently permed or curled hair.

Precautions During Use of Ketoconazole

Tell your doctor or pharmacist if your symptoms are not improving or getting worse during ketoconazole treatment or if you develop signs and symptoms of irritated skin or an allergic reaction. Inform your doctor if you become pregnant while on this medicine.

Ketoconazole Drug Interactions

The use of ketoconazole along with certain other drugs can affect how the medicines work. Possible drug interactions between ketoconazole and other medicines can also increase the risk of severe adverse events. Your doctor may change the dose of your medications or monitor you carefully for possible side effects if there are known interactions between ketoconazole and your other medicines.

Give your doctor or pharmacist a complete list of your medications, including prescription medications, non-prescription medicines, dietary supplements, and herbal remedies. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription and non-prescription medicines.

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