Ketoconazole (Ketoforce 200 mg) 200 mg tablet is an imidazole antifungal agent used to treat serious fungal infections in patients who have failed or are intolerant to other therapies. It is also used to treat a disorder of the adrenal glands known as Cushing’s syndrome, where the body produces an excess of cortisol.
Drug =Ketoconazole
Number of Pills Per Order = 10
Strength =200 mg
Manufacturer = Healing Pharma
How To Take
This medicine should be taken together with food or immediately after a meal. Try to make it at the same time each day.
Ketoconazole must be taken regularly for it to be effective. Continue taking this medicine even when you feel better.
Take Ketoconazole precisely as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Dosage Ketoconazole (Ketoforce 200 mg) 200 mg
Adult: Cushing’s syndrome: Initial: 400-600 mg daily, may be increased by 200 mg/day increments every 7-28 days if tolerated, according to the patient’s urinary free or plasma cortisol levels. The maintenance dose range is 600-800 mg daily. Maximum of 1,200 mg/day. All doses are given in 2 or 3 divided doses. Dose reduction or discontinuation may be required based on patient adrenal or liver function (refer to detailed product guidelines).
Systemic fungal infection In patients who have failed or are intolerant to other therapies: blastomycosis, coccidioidomycosis, histoplasmosis, chromomycosis, and paracoccidioidomycosis: 200 mg once daily, may increase to 400 mg once daily if clinical response is not obtained. Continue treatment until fungal infection is resolved.
Missed Dose
If you miss a dose, skip the missed dose and return to your usual dosing schedule. If you often forget to take your medicine, let your doctor and pharmacist know.
Do not double a dose under any circumstances.
Overdose of Ketoconazole (Ketoforce 200 mg) 200 mg
Signs of overdose may include the following:
- Signs of adrenal insufficiency, e.g., severe nausea, vomiting, anorexia, weakness, severe fatigue.
Seek medical help immediately.
Contraindications
People with the following medical conditions should not take Ketoconazole:
- Hypersensitivity
- Concomitant use with CYP3A4 substrates (e.g., cisapride, dofetilide, dronedarone, quinidine, disopyramide, pimozide, sertindole, mizolastine, lurasidone, quetiapine, methadone, ranolazine, eplerenone, halofantrine, triazolam, alprazolam, midazolam, nisoldipine, felodipine, irinotecan, everolimus, sirolimus, paritaprevir/ombitasvir, saquinavir/ritonavir), HMG-CoA reductase (e.g., simvastatin, lovastatin), ergot alkaloids (e.g., ergotamine, ergometrine), colchicine, telithromycin, clarithromycin, fesoterodine and solifenacin
- Acute or chronic hepatic impairment
- Pregnancy (with Cushing syndrome) and lactation (oral)
Side Effects
Ketoconazole may have the following side effects:
- Adrenal suppression
- QT prolongation
- Bone fragility
- Abnormal liver function tests
- Hypersensitivity reactions (e.g., anaphylaxis, angioedema).
- Thrombocytopenia
- Photophobia
- Nausea
- Vomiting
- Diarrhea
- Dyspepsia
- Constipation
- Abdominal pain
- Flatulence
- Asthenia
- Malaise
- Hot flush; topical: oily/dry hair, application site reactions (e.g., irritation, burning sensation, erythema, swelling).
- Jaundice
- Hepatitis
- Urticaria
- Increased hepatic enzymes
- Decreased platelet count
- Alcohol intolerance
- Anorexia
- Peripheral edema
- Myalgia
- Arthralgia
- Headache
- Dizziness
- Somnolence
- Dysgeusia
- Paraesthesia
- Insomnia
- Nervousness
- Menstrual disorder
- Erectile dysfunction
- Azoospermia
- Gynaecomastia
- Pruritus
- Rash
- Alopecia
- Photosensitivity
- Dermatitis
- Xeroderma
- Epistaxis
- Orthostatic hypotension
Potentially Fatal:
- Hepatotoxicity, e.g., hepatic necrosis
- Cirrhosis and failure or requiring liver transplantation
Warnings
Do not use Ketoconazole in people with the following conditions:
- Allergic reactions to similar medicines, such as fluconazole and Itraconazole
- Liver disease
- Pregnancy
- Lactation
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- Quinidine
- Dofetilide
- Disopyramide
- Dronedarone
- Ranolazine
- Oral midazolam
- Triazolam
- Alprazolam
- Pimozide
- Sertindole
- Lurasidone
- Quetiapine
- Ergotamine
- Ergometrine
- Dihydroergotamine
- Sirolimus
- Everolimus
- Simvastatin
- Lovastatin
- Mizolastine
- Irinotecan
- Halofantrine
- Dabigatran
- Cisapride
- Carbamazepine
- Phenytoin
- Rifampicin
- Rifabutin,
- Isoniazid
- Eplerenone
- Tolvaptan
- Nisoldipine
- Felodipine
- Verapamil
- Nadolol
- Digoxin
- Indinavir
- Ritonavir
- Saquinavir
- Nevirapine
- Maraviroc
- Budesonide
- Dexamethasone
- Methylprednisolone
- Salmeterol
- Ranitidine
- Omeprazole
- Sildenafil
- Tadalafil
- Vardenafil
- Repaglinide
- Saxagliptin
- Tolbutamide
- Fentanyl
- Alfentanil
- Oxycodone
- Vinca alkaloids
- Busulfan
- Docetaxel
- Crizotinib
- Dasatinib
- Warfarin
- Apixaban
- Rivaroxaban
- Cilostazol
- St. John’s wort
- Antacids
- Sucralfate
Inform your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and non-prescription medicines.
This list does not include all medicines that may interact with Ketoconazole.
How Does Ketoconazole (Ketoforce 200 mg) 200 mg Work?
Ketoconazole is an imidazole antifungal agent that inhibits the activity of fungal CYP450, thereby it decreases the biosynthesis of ergosterol and inhibits the formation of the fungal cell membrane. It is also a potent inhibitor of cortisol and aldosterone synthesis due to its ability to block several CYP450 enzymes in the adrenal glands.
Uses
Ketoconazole is used to treat the following conditions:
- Cushing’s syndrome
- Systemic fungal infection
- Cutaneous candidiasis; Tinea corporis; Tinea cruris; Tinea manuum; Tinea pedis
- Pityriasis Versicolor
- Seborrhoeic dermatitis
- Dandruff
Special Precautions and Connected Warnings
Take special precautions if you have the following conditions:
- Patients with achlorhydria
- Prostate cancer
- Central nervous system infection
- Adrenal insufficiency; under prolonged stress (e.g., major surgery, intensive care)
- Children pregnancy and lactation (topical)
- Avoid alcohol.
Storage Conditions
- Tab: Store between 20-25°C and protected from light.
- Store in a cool, dry place away from the reach of children.
- Do not use Ketoconazole that is expired or out of date.
