Nizoral

Generic name: Ketoconazole

What is Nizoral?

Nizoral, a broad-spectrum antifungal drug available in tablet form, may be given to treat several fungal infections within the body, including oral thrush and candidiasis.

It may also be given to treat severe, hard-to-treat fungal skin infections that have not cleared up after treatment with creams, ointments or the oral antifungal drug griseofulvin, or in those individuals who are unable to take griseofulvin.

What is the most important information I should know about Nizoral?

In some people, Nizoral may cause serious or even fatal damage to the liver. Before starting to take Nizoral, and at frequent intervals while you are taking it, you should have blood tests to evaluate your liver function. Tell your doctor immediately if you experience any signs or symptoms that could mean liver damage: these include unusual fatigue, loss of appetite, nausea or vomiting, yellowing of the eyes or skin, dark urine, or pale stools.

In rare cases, people have had anaphylaxis (a life-threatening allergic reaction) after taking their first dose of Nizoral. Symptoms may include difficulty breathing; tightness in the chest; swelling of the eyelids, face, or lips; or rash or hives. If this happens, seek immediate medical care.

Do not drive or perform other possibly unsafe tasks until you know how you react to Nizoral; this drug may cause dizziness or drowsiness. These effects may be worse if you take it with alcohol or certain medicines.

Use of alcohol with Nizoral has rarely caused symptoms such as flushing, rash, swelling of the hands and feet, nausea, and headache. Talk with your doctor before drinking alcohol while taking Nizoral

Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.

Nizoral only works against fungi; it does not treat viral infections (eg, the common cold) or bacterial infections.

Be sure to use Nizoral for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The infection could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.

Nizoral may increase the risk of low blood sugar from your diabetes medicine. Check blood sugar levels closely. Consult your doctor before changing the dose of your diabetes medicine.

Hormonal birth control (eg, birth control pills) may not work as well while you are using this medicine. To prevent pregnancy, use an extra form of birth control (eg, condoms).

Use of Nizoral along with certain other medicines may increase your risk of serious and sometimes fatal heart problems, including irregular heartbeat. Do not take Nizoral if you are also taking astemizole, cisapride, or terfenadine.

Who should not take Nizoral?

Do not take Nizoral if you are sensitive to it or have ever had an allergic reaction to it. Never take Nizoral together with astemizole, cisapride, terfenadine, or triazolam. Rare, but sometimes fatal reactions have been reported when these drugs are combined.

What should I tell my doctor before I take the first dose of Nizoral?

Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Nizoral. Also, talk to your doctor about your complete medical history, especially if you have low stomach acid, a history of liver disease, blood problems, or if you regularly use, abuse or are dependent on alcohol.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults: The usual starting dose is a single daily administration of 200 mg (one tablet). In very serious infections or if you are unresponsive within the expected time, the dose of Nizoral may be increased to 400 mg (two tablets) once daily.

Children over 2 years: The usual starting dose is a single daily dose of 3.3 to 6.6 mg/kg.

Nizoral has not been studied in children under 2 years of age.

How should I take Nizoral?

You should keep taking the drug until tests show that your fungal infection has subsided. If you stop too soon, the infection might return.

Nizoral can be taken with or without food. You may want to take Nizoral tablets with meals to avoid stomach upset.

Do not take an antacid within 1 hour before or 2 hours after you take Nizoral.

Hormonal birth control (eg, birth control pills) may not work as well while you are using this medicine. To prevent pregnancy, use an extra form of birth control (eg, condoms).

What should I avoid while taking Nizoral?

Avoid alcohol and do not take with antacids. If antacids are necessary, you should wait 2 to 3 hours before taking them.

Do not drive or perform other possibly unsafe tasks until you know how you react to Nizoral; this drug may cause dizziness or drowsiness.

Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.

Do not take Nizoral if you are also taking astemizole, cisapride, or terfenadine.

What are possible food and drug interactions associated with Nizoral?

If Nizoral is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Nizoral with the following: alcohol, antacids, anticoagulants (blood thinners), anti-ulcer medications, astemizole, cisapride, cyclosporine, digoxin, drugs that relieve spasms, isoniazid, methylprednisolone, midazolam, oral diabetes drugs, phenytoin, rifampin, tacrolimus, terfenadine, theophyllines, and triazolam.

What are the possible side effects of Nizoral?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: nausea, stomach pain or upset, vomiting

In rare cases, people have had anaphylaxis (a life-threatening allergic reaction) after taking their first dose of Nizoral. Symptoms may include difficulty breathing; tightness in the chest; swelling of the eyelids, face, or lips; or rash or hives. If this happens, seek medical care at once.

In some people, Nizoral may cause serious or even fatal damage to the liver. Tell your doctor immediately if you experience any signs or symptoms that could mean liver damage. These include unusual fatigue, loss of appetite, nausea or vomiting, yellowing of the eyes or skin, dark urine, or pale stools.

Can I receive Nizoral if I am pregnant or breastfeeding?

The effects of Nizoral during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding. Nizoral is found in breast milk. Do not breastfeed while using Nizoral.

What should I do if I miss a dose of Nizoral?

Take the forgotten dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take double doses.

How should I store Nizoral?

Store Nizoral between 59 and 77 degrees F (15 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Nizoral out of the reach of children.