Ketoconazole belongs to the family of medications called antifungals. It is used to treat fungal infections of the skin (ringworm, athlete's foot, and jock itch) and nails. It is also used to treat "sun fungus" (tinea versicolor, pityriasis versicolor).

The shampoo is used to treat and prevent conditions such as dandruff and seborrheic dermatitis. Ketoconazole works by preventing the fungus from making normal cell walls, thereby stopping fungal growth.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

Ketoconazole cream: The cream is usually applied once daily to the affected and immediate surrounding area for a treatment period of 2 to 6 weeks, depending on condition being treated. For treatment of seborrheic dermatitis, the cream is usually used twice daily for 4 weeks.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

Ketoconazole should be used for the recommended duration of treatment, even if the symptoms seem to have disappeared. This will reduce the chance of the fungal infection returning.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, use it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not apply a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, do not allow it to freeze, and keep it out of reach of children.

Each gram of white, odourless cream contains ketoconazole 20 mg (2%). Nonmedicinal ingredients: butylated hydroxyanisole (BHA), isopropyl myristate, polysorbate 60, polysorbate 80, propylene glycol, sorbitan monostearate, stearyl and cetyl alcohols, and water.

Ketoconazole should not be used by anyone who is allergic to ketoconazole or to any of the ingredients of the medication.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

For shampoo only

• dry skin
• dryness or oiliness of the hair and scalp

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• itching, stinging, or irritation not present before use of this medication
• skin rash (with cream only)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergy: If a reaction suggesting allergy or chemical irritation should occur, stop using ketoconazole cream or shampoo and contact your doctor. Signs of an allergic reaction may include itchiness, rash, or swelling of the affected area.

Eye concerns: Ketoconazole cream should never be used to treat infections of the eye. If ketoconazole shampoo gets in the eyes, flush the eyes well with clear water for several minutes.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: It is not known if ketoconazole shampoo or cream pass into breast milk. If you are breast-feeding and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Use of the shampoo by children under 12 years of age is not recommended except on the advice of a doctor.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.