Compare Itraconazole vs. Ketoconazole

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

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Sporanox (itraconazole)

Prescription only

Nizoral (Ketoconazole)

Prescription or OTC
Treats fungal infections.

Sporanox (itraconazole) is effective oral medication that treats many different kinds of fungal infections. However, it has the potential to interact with a lot of other medications and has a few serious but rare side effects.

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
  • Sporanox (itraconazole) is effective in treating infections caused by many different types of fungi.
  • Available as a generic in the capsule form.
  • Sporanox (itraconazole) can be used by people who have kidney problems.
  • 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
  • The liquid solution is especially likely to cause stomach upset like nausea and diarrhea.
  • Sporanox (itraconazole) is not a good choice for simple fungal infections (like nail infections) in people who have congestive heart failure because it can cause high blood pressure and swelling of the limbs.
  • Sporanox (itraconazole) isn't absorbed in the same way by everyone. You'll likely need to get lab tests done to check on its levels in the blood.
  • Sporanox (itraconazole) can cause serious side effects like allergic reactions, liver toxicity, nerve pain, or hearing loss.
  • Sporanox (itraconazole) has a lot of drug interactions. Let your doctor or pharmacist know about all of the medications you're taking.
  • 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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Used for
  • Salvage therapy for invasive aspergillosis
  • Blastomycosis
  • Oropharyngeal and esophageal candidiasis
  • Histoplasmosis
  • Onychomycosis
  • Vulvovaginal candidiasis in HIV-infected patients
  • Coccidioidal meningitis in HIV-infected patients
  • Coccidioidal pneumonia in HIV-infected patients
  • Cryptococcosis in HIV-infected patients
  • Disseminated microsporidiosis in HIV-infected patients
  • Penicilliosis in HIV-infected patients
Dosage forms
  • Pill
  • Liquid
  • Pill
  • Cream, gel, or ointment
  • Foam
  • Shampoo
Price
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Reviews
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Side effects
14possible side effects
  • Nausea
    11%
  • Rash
    9%
  • Vomiting
    5%
  • Swelling due to fluid retention
    4%
  • Headache
    4%
  • Diarrhea
    3%
  • Tiredness
    3%
  • Fever
    3%
  • Itching
    3%
  • High blood pressure
    3%
  • Lowered liver function
    3%
  • Abdominal pain
    2%
  • Dizziness
    2%
  • Low potassium
    2%
See more detailed side effects
1possible side effects
  • Any side effect
    5%
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Risks and risk factors
  • Congestive Heart Failure
    • History of congestive heart failure
  • Drug interactions
  • Liver toxicity
  • Irregular heartbeat
    • Taking other medications that can produce an irregular heartbeat
  • Do not switch between the capsules or liquid forms
See more detailed risks and warnings
  • Severe allergic reactions
    • Asthma
See more detailed risks and warnings