Nizoral is a medication that contains the active ingredient ketoconazole. It is also known by the names Ketozole and Fungoral. Nizoral is used to treat infections caused by fungi, such as dandruff, athlete’s foot, and ringworm.
The pricing structure for Nizoral is set between £0.93 and £1.62 for every pills. It’s reflective of the size of the packaging and ingredient concentration (30 or 360 mg).
Nizoral, with the generic name ketoconazole, is an antifungal medication primarily used to treat fungal infections. It belongs to the class of imidazole antifungals and functions by inhibiting the synthesis of ergosterol, crucial for fungal cell membranes.
Nizoral exerts its antifungal effect by disrupting the fungal cell membrane. It does so by inhibiting the enzyme lanosterol 14-α-demethylase, essential for converting lanosterol to ergosterol. The inhibition leads to the accumulation of lanosterol and other toxic sterols, causing increased membrane permeability and cell death.
Nizoral is indicated for various fungal infections, including severe systemic mycoses such as blastomycosis, histoplasmosis, and coccidioidomycosis. It is also used to treat chronic mucocutaneous candidiasis and dermatophyte infections such as tinea corporis, tinea cruris, and tinea pedis.
The dosage of Nizoral depends on the type and severity of the infection. The typical oral dose for adults is 200 mg once daily. If no improvement is seen within a specified period, the dosage may be increased to 400 mg per day. The medication should be taken with food to enhance absorption.
Nizoral is absorbed variably from the gastrointestinal tract, with peak plasma concentrations reached within 1 to 2 hours after oral administration. The drug is extensively bound to plasma proteins (84-99%). It is metabolized in the liver and eliminated primarily via the feces, with a half-life of approximately 2 to 8 hours.
Nizoral is contraindicated in patients with known hypersensitivity to ketoconazole or any excipients in the formulation. It should not be used in conjunction with certain medications like cisapride, midazolam, or triazolam due to the risk of serious cardiovascular events such as QT prolongation.
Nizoral can interact with a variety of medications. For instance, it inhibits cytochrome P450 3A4 (CYP3A4), leading to elevated plasma concentrations of drugs metabolized by this enzyme. Medications like anticoagulants, antineoplastics, and immunosuppressants may have altered effects when taken with Nizoral.
Common adverse reactions to Nizoral include nausea, vomiting, abdominal pain, and pruritus. More serious side effects can include hepatotoxicity, manifested as jaundice, elevated liver enzymes, and, in rare cases, liver failure requiring transplantation. Endocrine problems such as adrenal insufficiency and gynecomastia have also been reported.
Regular monitoring of liver function tests is essential when using Nizoral due to its hepatotoxic potential. Baseline assessments of liver enzymes should be done before starting therapy and periodically during treatment. Monitoring adrenal function is also advisable, especially for long-term use or in patients with symptoms of adrenal insufficiency.
In pediatric patients, the safety and efficacy of Nizoral have not been established for children under 2 years of age. For elderly patients, no specific dosage adjustments are recommended, but caution is advised due to the increased likelihood of concurrent hepatic dysfunction. Pregnant women should only use Nizoral if the potential benefits justify the potential risks to the fetus.
Nizoral should be stored at controlled room temperature, between 15°C to 25°C (59°F to 77°F). Protect the medication from light and moisture. Ensure that the medication is kept out of reach of children and is stored in its original container until ready for use.
Clinical trials have demonstrated the efficacy of Nizoral in treating various systemic and superficial fungal infections. Studies indicate that the drug is particularly effective for recalcitrant or severe infections where other antifungal treatments have failed. However, due to its side effect profile, it is generally reserved for cases that do not respond to safer antifungals.