Ketoconazole Aurobindo (Ketoconazole)

Ketoconazole is an azole antifungal that disrupts fungal cell membrane synthesis, making it effective for a range of superficial mycoses.

• Tinea corporis: reduces lesion size and clears the fungal infection.
• Tinea cruris: alleviates itching and resolves the rash caused by dermatophytes.
• Tinea pedis: eliminates foot fungus and improves skin condition.
• Seborrheic dermatitis: controls flaking and redness on scalp and skin.
• Pityriasis versicolor: clears discolored patches by eradicating Malassezia species.

• Ketoconazole inhibits the fungal enzyme lanosterol 14α-demethylase, a key step in ergosterol synthesis. By blocking ergosterol production, the drug compromises fungal cell membrane integrity, leading to increased permeability and ultimately cell death. This action is selective for fungi, sparing human cells.

Topical ketoconazole may cause local skin reactions, ranging from mild irritation to rare severe events.

Common Side Effects

• Burning sensation at application site.
• Itching or pruritus.
• Dryness or scaling of the skin.
• Redness or erythema.
• Stinging or tingling.
• Contact dermatitis.

Serious or Rare Side Effects

• Severe allergic reaction (anaphylaxis).
• Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatic toxicity (rare with extensive use).
• Photosensitivity leading to severe sunburn.
• Skin necrosis or ulceration.

When using topical ketoconazole, observe the following precautions to minimize risks.

• Avoid application on broken or inflamed skin: may increase systemic absorption.
• Do not apply near eyes, mouth or mucous membranes: risk of irritation.
• Limit treatment duration as advised by a healthcare professional: prolonged use can promote resistance.
• Perform a patch test if history of skin sensitivity: monitor for adverse reaction.
• Use with caution in patients with hepatic impairment: systemic exposure may be higher.
• Store at below 25°C: keep in the original packaging, protect from moisture and heat.

Ketoconazole can interact with other medicines, especially when systemic absorption occurs.

Major Interactions (Avoid)

• Concurrent systemic azole antifungals: may lead to additive toxicity.
• Oral warfarin: ketoconazole can potentiate anticoagulant effect, increasing bleeding risk.
• Systemic corticosteroids: may enhance systemic exposure and suppress adrenal function.

Moderate Interactions (Monitor Closely)

• Topical products containing alcohol or irritants: may increase skin irritation.
• Other topical antifungals or keratolytics: monitor for overlapping toxicity.
• Sunscreen or photoprotective agents: ketoconazole may increase photosensitivity, adjust usage.