Ketoconazole: Uses, How It Works, Medicines
Ketoconazole is an antifungal medicine used in a shampoo to treat dandruff, seborrhoeic dermatitis and pityriasis versicolor, conditions linked to yeast on the skin. It is put on the scalp or skin and rinsed off, and very little reaches the blood. It works on fungi only and is used as the label or a doctor advises.
Also known as: Ketoconazole 2% shampoo, Ketoconazole shampoo, Nizoral, Nizral, Anti-dandruff ketoconazole
Pharmacist review in progress. This page is based on the sources listed below and is being checked by our registered pharmacist.
How does Ketoconazole work?
Ketoconazole stops yeasts and fungi from making a substance called ergosterol that their outer cell layer needs. Without it the yeast cannot grow, which reduces flaking and itching.
How to take Ketoconazole
Follow the label or your doctor's advice. The shampoo is lathered onto the wet scalp or affected skin, left for a few minutes as the pack says, and rinsed off.
Side effects of Ketoconazole
Ketoconazole shampoo is usually well tolerated. When side effects happen they are mostly local.
Uncommon or mild
- Itching or a burning feeling on the skin
- Skin irritation or dryness
- Oily or dry hair and scalp
- Changes in hair texture
- Increased hair loss for a short time (uncommon)
Rare but serious: get medical help
- Hives, widespread rash, swelling of the face or lips or difficulty breathing. Stop using it and get medical help immediately
Who should be careful
Some people need extra care with ketoconazole shampoo.
When the label says not to use it
- Allergy to ketoconazole or to any ingredient of the shampoo
- Keep it out of the eyes; rinse well with water if it gets in
- It may remove the curl from permed hair and can change hair colour or texture in some people
- See a doctor if the scalp is red or swollen, if there are patches on the face or body, or if there is no improvement after about 4 weeks
- Children: safety and benefit have not been established, so ask a doctor
- Pregnancy and breastfeeding: very little reaches the blood from the scalp, but ask a doctor first
Medicines and things that interact with Ketoconazole
Used as a shampoo, ketoconazole is not known to interact with other medicines because it is not found in the blood after scalp use. Tell a doctor about other treatments you use on your scalp.
- Other medicated scalp products used together: ask a doctor or pharmacist first
If someone takes too much
Using too much shampoo is unlikely to be serious. If it is swallowed, call 112 or go to the nearest hospital and take the pack with you.
Regulatory status in India
Ketoconazole 2% shampoo is sold in India as a medicated antifungal shampoo. Single-ingredient ketoconazole is not on the CDSCO list of medicines banned under section 26A, but several fixed-dose combinations that contain ketoconazole with steroids, antibiotics and other ingredients are, so check the ingredient list on the pack.
Type of medicine
Ketoconazole belongs to this type of medicine.
Medicines that contain Ketoconazole
These medicines sold in India contain Ketoconazole. They are listed A to Z, not ranked.
- Nizral 2% · 2% medicated shampoo
What is Ketoconazole used for?
Medicines that contain Ketoconazole are used for these conditions.
Other medicines of the same type
These active ingredients are of the same type as Ketoconazole.
Common questions
What is ketoconazole shampoo used for?
Ketoconazole shampoo is used to treat dandruff, seborrhoeic dermatitis and pityriasis versicolor, which are linked to yeast on the skin. It is not a general hair-growth or hair-care product. Ask a doctor if the problem does not improve.
How long should I use ketoconazole shampoo?
Use it for the time on the pack or advised by your doctor. The NHS suggests trying an anti-dandruff shampoo for up to 4 weeks. See a doctor if there is no improvement then, or if the scalp is red, swollen or very itchy.
Is ketoconazole shampoo absorbed into the body?
Very little. The US label reports that ketoconazole was not detected in the blood of people who shampooed regularly for many months. This is different from ketoconazole tablets, which are a separate medicine with different risks.
Sources
- Ketoconazole shampoo, 2%: prescribing information (ANI Pharmaceuticals). DailyMed, US National Library of Medicine
- Ketoconazole: a medicine for fungal skin infections and dandruff. NHS (UK)
- Dandruff. NHS (UK)
- ATC/DDD Index: D01AC08 ketoconazole. WHO Collaborating Centre for Drug Statistics Methodology
- List of drugs prohibited for manufacture and sale through gazette notifications under section 26A of the Drugs & Cosmetics Act 1940. Central Drugs Standard Control Organisation (CDSCO)