Prescription or OTCLower-cost generic available



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Treats fungal infections.

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Prescription or OTCLower-cost generic available

Our pharmacists’ bottom line

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.

  • 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.
  • 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.

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Side effects for Nizoral (Ketoconazole)

From clinical trials of Ketoconazole / Fungal infections of the skin (2%)  ( 1113)

  • Any side effectAny side effect5% for Ketoconazole vs.2% for placebo

What to expect when you take Nizoral (Ketoconazole)

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Tips from our pharmacists
  • The shampoo is meant to be used once every 3 to 4 days, while the cream, gel and foam are meant to be used one to three times a day.
  • It can take at least 2 to 6 weeks for the infection to completely clear, and it can take 3 to 6 months before the skin returns to its original color for some infections.
  • Make sure Nizoral (Ketoconazole) doesn't get into the eyes.
  • If you're using the foam, spray the foam into the cap, not your hands since it can melt before you put it on, and apply onto the skin, not the hair.
  • Can cause redness, swelling, and an irritated or burning sensation to the area where you put Nizoral (Ketoconazole) on.

Risks and Warnings for Nizoral (Ketoconazole)

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    • Higher risk if:
    • Asthma

    Nizoral (Ketoconazole) can contain sodium sulfite anhydrous, a sulfite that can cause allergic-type reactions including severe asthmatic episodes in people with asthma.

Means that some groups have a high risk of experiencing this side effect

Tips from pharmacists and people taking Nizoral (Ketoconazole)

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The FDA category for this medication is C. It is advised that you: Weigh risks vs. benefits