Ketoconazole

Administration

• Type: Antifungal
• Dosage Forms: Tablet, 200mg
• Routes of Administration: PO, topical
• Common Trade Names:

Adult Dosing

Fungal infections

• 200-400mg PO qday

Prostate cancer

• 400mg PO q8h

Pediatric Dosing

Fungal infectionss (2 years and up)

• 3.3-6.6mg/kg PO qday

Special Populations

• Pregnancy Rating: C, adverse events have been seen in animal studies
• Lactation risk: Excreted in breast milk, not recommended by manufacturer.

Renal Dosing

• Adult: no adjustment
• Pediatric: no adjustment

Hepatic Dosing

• Adult: contraindicated in liver disease
• Pediatric: contraindicated in liver disease

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• Hepatotoxicity
• Adrenal insufficiency
• Hypersensitivity reaction
• Anaphylaxis
• Thrombocytopenia
• Leukopenia
• Hemolytic anemia

Common

• Nausea
• Abdominal pain
• Dizziness
• Diarrhea
• Headache
• Pruritis
• Lethargy
• Gynecomastia

Pharmacology

• Half-life: 8 h
• Metabolism: Liver (CYP450)
• Excretion: feces > urine

Mechanism of Action

• Inhibits synthesis of cell membrane ergosterol