Ketoconazole is like an antibiotic but is used to treat fungal infections. Nizoral tablets belong to a class of drugs known as the imidazoles. Generic Nizoral is used in the treatment of fungal infections by interfering with their growth and repair mechanisms.
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Ketoconazole should be given with food. Do not give ketoconazole within 2 hours of an antacid. Blood tests or other medical evaluations may be required by your doctor to monitor progress and side effects. Ketoconazole Tablets require acidity for dissolution. If concomitant antacids, anticholinergics, and H2 -blockers are needed, they should be given at least two hours after administration of Ketoconazole Tablets. In cases of achlorhydria, the patients should be instructed to dissolve each tablet in 4 mL aqueous solution of 0.2 N HCl. For ingesting the resulting mixture, they should use a drinking straw so as to avoid contact with the teeth.
Most of the reported cases of hepatic toxicity have to date been in patients treated for onychomycosis. Of 180 patients worldwide developing idiosyncratic liver dysfunction during Ketoconazole Tablet therapy, 61.3% had onychomycosis and 16.8% had chronic recalcitrant dermatophytoses. In rare cases anaphylaxis has been reported after the first dose. Several cases of hypersensitivity reactions including urticaria have also been reported. The maximum "no-effect" dose level in these studies was 20 mg/kg (2.5 times the maximum recommended human dose). The mechanism responsible for this phenomenon is obscure. Limited studies in dogs failed to demonstrate such an effect on the metacarpals and ribs.
Patients should be instructed to report any signs and symptoms which may suggest liver dysfunction so that appropriate biochemical testing can be done. Ketoconazole Tablets may alter the metabolism of cyclosporine, tacrolimus, and methylprednisolone, resulting in elevated plasma concentrations of the latter drugs. Dosage adjustment may be required if cyclosporine, tacrolimus, or methylprednisolone are given concomitantly with Ketoconazole Tablets.
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