Ketoconazole

Y. Vivian Tsai, Pharm.D., Edina Avdic, Pharm.D.
Pediatric Dosing Author: Bethany Chalk, Pharm.D., BCPPS

INDICATIONS

Ketoconazole tablets
- Treatment of the following systemic fungal infections in patients who have failed or who are intolerant to other therapies: blastomycosis, coccidioidomycosis, histoplasmosis, chromomycosis, and paracoccidioidomycosis.
  - Note: despite FDA approval, due to the potential for severe hepatitis, adrenal insufficiency, and drug-drug interactions, systemic ketoconazole should not be used as a first-line treatment for any fungal infections. Additionally, it should not be used for the treatment of onychomycosis, cutaneous dermatophyte infections, or Candida infections.
Ketoconazole cream 2%
- Treatment of tinea corporis, tinea cruris and tinea pedis caused by Trichophyton rubrum, T. mentagrophytes and Epidermophyton floccosum
- Treatment of tinea (pityriasis) versicolor caused by Malassezia furfur (Pityrosporum orbiculare)
- Treatment of cutaneous candidiasis caused by Candida spp.
- Treatment of seborrheic dermatitis.
Ketoconazole shampoo 2%
- Treatment of tinea (pityriasis) versicolor caused by or presumed to be caused by Pityrosporum orbiculare (also known as Malassezia furfur or M. orbiculare).
Ketoconazole foam 2%
- Treatment of seborrheic dermatitis in immunocompetent patients ≥12 years old
Levoketoconazole tablets
- Treatment of endogenous hypercortisolemia in adults with Cushing syndrome for whom surgery is not an option or has not been curative.
  - Not approved for fungal infections.

Treatment of hyperadrenalism
Booster for calcineurin inhibitor to increase levels in solid organ transplant recipients

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