Ketoconazole, Oral kee-toh-KOH-na-zol

What are other names for this medicine?

Type of medicine: antifungal; anti-infective

Generic and brand names: ketoconazole, oral; Nizoral

What is this medicine used for?

This medicine is taken by mouth to treat fungal infections in various parts of the body.

It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Be sure to tell your healthcare provider if you have ever had:

• achlorhydria (lack of stomach acid) or hypochlorhydria (decreased amount of stomach acid)
• an allergic reaction to any medicine
• liver disease

Some medicines may cause serious, even fatal, problems if taken with this medicine. Tell your healthcare provider about all of the medicines you take.

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or take it longer than prescribed. Do not stop taking this medicine without your healthcare provider's approval, even if you feel better.

Take this medicine with food. Taking it with meals may lessen the chance the drug will upset your stomach.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

An acute overdose of this medicine is not likely to cause life-threatening symptoms. If you think that you or anyone else may have taken too much of this medicine, call the poison control center at 800-222-1222.

What should I watch out for?

You need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

Contact your healthcare provider right away if you develop severe tiredness, loss of appetite, nausea, vomiting, yellowish skin or eyes, dark urine, or light-colored bowel movements. These may be symptoms of liver problems.

Alcohol may increase the risk of liver problems. Alcohol may also a cause unpleasant reaction with this medicine such as flushing, sweating, fast heartbeat, headache, nausea, and vomiting. Do not drink alcohol while you are taking this medicine.

Diabetics: This medicine may affect your blood sugar level and change the amount of diabetes medicines you may need. Talk to your healthcare provider about this.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical treatment or call 911 for help): Allergic reaction (hives; itching; rash; tightness in your chest; swelling of your lips, tongue, or throat; trouble breathing).

Serious (report these to your healthcare provider right away): Severe tiredness or weakness, fast heartbeat, chest pain, loss of appetite, yellowish skin or eyes, dark urine, light-colored bowel movements, thoughts of suicide, depression, numbness or tingling in legs or arms, unusual bruising or bleeding.

Other: Headache, abdominal pain, nausea, vomiting, diarrhea, dizziness, itching, tiredness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• alcohol
• alfentanil (Alfenta)
• alfuzosin (Uroxatral)
• antacids (take antacids 2 hours apart from doses of this medicine)
• antibiotics such as clarithromycin (Biaxin, Biaxin XL), erythromycin (Ery-Tabs, E.E.S.), and telithromycin (Ketek)
• antidepressants such as nefazodone and trazodone (Desyrel)
• anti-HIV medicines such as delavirdine (Rescriptor), efavirenz (Sustiva), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), saquinavir (Invirase), and zidovudine (Retrovir)
• antiarrhythmics (medicines to treat irregular heartbeat) such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), and quinidine
• anticancer medicines such as busulfan (Myleran), docetaxel (Taxotere), vinblastine, vincristine, and vinorelbine (Navelbine)
• benzodiazepines such as alprazolam (Xanax), diazepam (Valium), midazolam (Versed), and triazolam (Halcion)
• bosentan (Tracleer)
• eletriptan (Relpax) (Do not take antifungal medicines within 72 hours of taking this medicine.)
• eplerenone (Inspra)
• antiseizure medicines such as carbamazepine (Tegretol), phenobarbital, and phenytoin (Dilantin)
• birth control pills (ask your healthcare provider if you need another form of birth control)
• buspirone (BuSpar)
• calcium channel blockers such as amlodipine (Norvasc), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Procardia, Adalat), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Isoptin, Verelan)
• cilostazol (Pletal)
• cisapride (Propulsid)
• corticosteroid medicines such as budesonide (Pulmicort), dexamethasone, fluticasone (Flovent), methylprednisolone (Medrol, Depo-Medrol), and prednisone
• digoxin (Lanoxin)
• ergot medicines such as bromocriptine (Parlodel), dihydroergotamine (D.H.E. 45), ergotamine (Ergomar), and methylergonovine (Methergine)
• H2 antagonists such as cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), and ranitidine (Zantac)
• immunosuppressants such as cyclosporine (Sandimmune, Gengraf, Neoral), sirolimus (Rapamune), and tacrolimus (Prograf, Protopic)
• isoniazid
• medicines to lower cholesterol (statins) such as atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), and simvastatin (Zocor)
• medicines to treat erectile dysfunction such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)
• narcotic pain relievers such as codeine (Tylenol #3), fentanyl (Duragesic), hydrocodone (Lorcet, Norco, Vicodin), methadone (Dolophine, Methadose), and oxycodone (Percodan, Percocet, Tylox)
• oral diabetes medicines such as chlorpropamide, glipizide (Glucotrol), glyburide (DiaBeta, Glynase), and tolbutamide
• quinine
• ramelteon (Rozerem)
• ranolazine (Ranexa)
• pimozide (Orap)
• medicines to block stomach acid such as dexlansoprazole (Kapidex), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (AcipHex)
• rifabutin (Mycobutin)
• rifampin (Rifadin, Rimactane)
• St. John's wort
• sucralfate (Carafate)
• tramadol (Ultram)
• warfarin (Coumadin)

The effects of this medicine may be increased if you take it with grapefruit juice. Talk with your healthcare provider about this.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.