Compare Terbinafine vs. Ketoconazole

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Lamisil (Terbinafine)

Prescription only

Nizoral (Ketoconazole)

Prescription or OTC
Treats fungal infections.

Lamisil (Terbinafine) has the highest cure rate of all antifungal medications, but you need to take it for a few weeks or months to see if it'll work for you.

Treats fungal infections.

Nizoral (Ketoconazole) is a medication used on your skin to treat fungal infections; however, it takes several weeks for full recovery, and the directions are specific to each type of medication.

Upsides
  • Recommended as a first-choice treatment for fungal infections. It has a high cure rate and very few side effects.
  • Available as a generic medication, so it's cheap.
  • It's the only antifungal medication that is available in different oral forms and can be used by children.
  • Recommended as a first choice medication to treat skin infections caused by fungi, including cradle cap, seborrheic dermatitis, and tinea versicolor.
  • Nizoral (Ketoconazole) isn't taken orally, so it doesn't cause liver issues.
  • Can be used with other medications to help control redness and swelling.
  • The 1% shampoo is available over-the-counter in the drugstore.
Downsides
  • It can take weeks to months to see any changes in the infection.
  • While Lamisil (Terbinafine) has the highest cure rate of all antifungal medications, there's still a chance it may not work.
  • Can cause headache, nausea, vomiting, and diarrhea.
  • The foams (Extina and Ketodan) and gel (Xolegel) are only available as brand name and can be more expensive.
  • The 2.5% shampoo and creams are available only by prescription, but are generic.
  • The shampoo has to be left on for at least 5-10 minutes after lathering before you rinse it off.
  • It can take a few weeks for the infection to clear and a few months before the skin returns to its normal color.
  • The fungal infections can be confused for other skin infections, so if Nizoral (Ketoconazole) doesn't work, it could be caused by another skin problem.
Used for
Dosage forms
  • Pill
  • Granule
  • Cream, gel, or ointment
  • Topical spray
  • Pill
  • Cream, gel, or ointment
  • Foam
  • Shampoo
Price
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Reviews
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Side effects
10possible side effects
  • Headache
    13%
  • Diarrhea
    6%
  • Rash
    6%
  • Dyspepsia
    4%
  • Nausea
    3%
  • Pruritus
    3%
  • Liver Enzyme Abnormalities
    3%
  • Taste Disturbance
    3%
  • Abdominal Pain
    2%
  • Flatulence
    2%
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1possible side effects
  • Any side effect
    5%
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Risks and risk factors
  • Liver damage
    • Past history of liver disease
    • Taking Lamisil (Terbinafine) by mouth
  • Changes in taste and smell
    • Taking Lamisil (Terbinafine) by mouth
  • Depression
    • Taking Lamisil (Terbinafine) by mouth
  • Skin rash
    • Taking Lamisil (Terbinafine) by mouth
  • Lupus
    • Past history of lupus
    • Taking Lamisil (Terbinafine) by mouth
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  • Severe allergic reactions
    • Asthma
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