Ketoconazole, Oral

Type of medicine: antifungal; anti-infective

Generic and brand names: ketoconazole, oral; Nizoral

This medicine is taken by mouth to treat fungal infections in various parts of the body.

It may also be used to prevent fungus infections following bone marrow transplants.

It may be used for other conditions as determined by your health care provider.

Be sure to tell your health care provider if you have ever had:

• achlorhydria (lack of stomach acid) or hypochlorhydria (decreased amount of stomach acid)
• an allergic reaction to any medicine
• liver or kidney disease

Some drugs may cause serious, even fatal, problems if taken with this medicine. Tell your health care provider about all of the medicines you take.

Females of childbearing age: This medicine is not usually given to pregnant women because it may harm the baby. If you are pregnant, tell your health care provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your health care provider right away. Do not breast-feed while you are receiving this medicine.

Take this medicine exactly as your health care provider prescribes. Do not take more or less or take it longer than prescribed. Do not stop taking this medicine without your health care provider's approval.

If you are taking the tablet or liquid form, you may take this medicine with food to lessen stomach upset. Take the medicine at the same time each day to help you remember to take it.

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your health care provider.

You may need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

Contact your health care provider right away if you develop severe tiredness, loss of appetite, nausea, vomiting, yellowish skin or eyes, dark urine, or light-colored bowel movements. These may be symptoms of liver problems.

Alcohol may increase the risk of liver problems. Do not drink alcohol while you are taking this medicine.

Diabetics: This medicine may affect your blood sugar level and change the amount of diabetes medicines you may need. Talk to your health care provider about this.

This medicine may make you drowsy or dizzy. Do not drive or operate machinery unless you are fully alert.

This medicine may make your eyes more sensitive to light. Stay away from bright lights and wear sunglasses when you need to be outdoors while you are taking this medicine.

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your health care provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your health care provider right away. If you cannot reach your health care provider right away, get emergency medical treatment or call 911 for help): Allergic reaction (hives; itching; rash; tightness in your chest; swelling of your lips, tongue or throat; trouble breathing).

Serious (report these to your health care provider right away): Severe tiredness, fast heartbeat, loss of appetite, nausea, vomiting, yellowish skin or eyes, dark urine, light-colored bowel movements.

Other: Headache, abdominal pain, diarrhea, fever, dizziness, drowsiness, enlarged breasts in men, impotence, sensitivity to light, itching.

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your health care provider if you are taking:

• alcohol
• antacids (take antacids 2 hours apart from doses of this medicine)
• anticancer medicines such as vinblastine (Velban), vincristine (Oncovin, Vincasar PFS), busulfan (Myleran), docetaxel (Taxotere), trimetrexate (Neutrexin), and vinorelbine (Navelbine)
• anti-HIV medicines such as indinavir (Crixivan), saquinavir (Invirase, Fortovase), nelfinavir (Viracept), nevirapine (Viramune), amprenavir (Agenerase), and ritonavir (Norvir)
• antihistamines such as astemizole (Hismanal) and terfenadine (Seldane), which have been withdrawn from the market
• antiarrhythmics (medicines to treat irregular heartbeat) such as quinidine (Quinora, Quinidex, Quinaglute, Cardioquin)
• benzodiazepines such as alprazolam (Xanax), diazepam (Valium), triazolam (Halcion), chlordiazepoxide (Librium), lorazepam (Ativan), and midazolam (Versed)
• calcium channel blockers such as amlodipine (Norvasc), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Procardia, Adalat), nimodipine (Nimotop), verapamil (Calan, Isoptin, Verelan), and nisoldipine (Sular)
• carbamazepine (Tegretol)
• cisapride (Propulsid)
• ergot medicines such as ergotamine (Ergomar) and dihydroergotamine (D.H.E. 45)
• H2 antagonists such as cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), and nizatidine (Axid)
• immunosuppressants such as azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), mycophenolate mofetil (Cellcept), sirolimus (Rapamune), and tacrolimus (Prograf, Protopic)
• isoniazid (Nydrazid, Laniazid)
• medicines to lower cholesterol (statins) such as atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), simvastatin (Zocor), and pravastatin (Pravachol)
• methylprednisolone (Medrol, A-Methapred, Adlone, Depo-Medrol)
• oral diabetes medicines such as chlorpropamide (Diabinese), acetohexamide (Dymelor), glipizide (Glucotrol), glyburide (DiaBeta, Micronase, Glynase), and tolbutamide (Orinase)
• phenytoin (Dilantin)
• pimozide (Orap)
• proton pump inhibitors such as omeprazole (Prilosec), esomeprazole (Nexium), pantoprazole (Protonix) and lansoprazole (Prevacid)
• quinidine (Quinora, Quinidex, Quinaglute, Cardioquin)
• rifabutin (Mycobutin)
• rifampin (Rifadin, Rimactane)
• St. John's wort
• sucralfate (Carafate)
• warfarin (Coumadin).
• zolpidem (Ambien).

The effects of this medicine may be increased if you take it with grapefruit juice. Discuss this with your health care provider.

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all health care providers who treat you about all the products you are taking.

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your health care provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.