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Elocof Health Tips: Review of Pharmacology of Ketoconazole

By Dr Lutoti Stephen

Today, we look at another antifungal drug that is commonly used. We commonly know it as nizoral or ketrozol.

These are just examples of brands on the market in Pharmacies, drug shops and clinics. There are other brands. Let us focus on the active ingredient called Ketoconazole.

Indications/ uses:
Ketoconazole is a medicine for treating the following conditions :
✓Dermatophytoses
✓malassezia folliculitis
✓ chronic mucocutaneous, cutaneous and oral pharyngeal candidiasis

Mechanism of action

Ketoconazole impairs the synthesis of Ergosterol, the main sterol of fungal cell membranes, allowing increased permeability and leakage of cellular components and causing cell death.

Dosage of Ketoconazole:
200-400mg daily according to indication ( max 1.2g daily)
For resistant vaginal candidiasis, 200-400mg daily for 1 week.
Children dose: 3mg/kg body weight.

Ketoconazole should be taken after meals.

Precautions to be taken when taking/ using Ketoconazole

There is need to monitor liver function if used for a long time, adrenal insufficiency, avoid drugs that reduce gastric secretions. It has disfulfirum-like effect.

Contraindications

Ketoconazole should be avoided in the following circumstances:

✓Pregnancy and lactation
✓Hepatic disorders
✓Concomitant administration with terfenadine, cisapride, astemizole, midazolam, Triazolam.

Drug interractions

Ketoconazole can interract with other medicines like Rifampicin, Isoniazid, Phenytoin, methyl Prednisone, alcohol.

A patient on Ketoconazole, should there not use these medicines at same sitting. Give 2 hours separation.

Pregnancy risk category : Ketoconazole is classified as Pregnancy category B3 drug.

Side effects

The following side effects have been reported following use of Ketoconazole :

✓Hepatitis
✓Anaphylaxis
✓GI disturbances
✓Nausea and vomiting
✓Headache
✓Rashes
✓Gynaecomastia
✓Paraesthesia
✓Thrombocytopenia

Note that these side effects do not occur in all patients and not each and every time Ketoconazole is used. If they become severe/serious, stop use of the drug. An alternative medicine can be recommended.

But remember to always choose Elocof syrup for cough, flu and sore throat. If symptoms persist, seek medical advise.

The Author is the proprietor of Eloipharm Uganda Limited,the Inventor of Elocof Herbal Medicine and the head of pharmacognosy department at Makerere University.

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