{"id":4099,"date":"2025-03-31T18:11:57","date_gmt":"2025-03-31T18:11:57","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/ketoconazole-txt\/"},"modified":"2025-03-31T18:11:57","modified_gmt":"2025-03-31T18:11:57","slug":"ketoconazole-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/ketoconazole-txt\/","title":{"rendered":"Ketoconazole.txt"},"content":{"rendered":"

Ketoconazole <\/h1>\n

CLINICAL USE <\/H3>
\nAntifungal agent

DOSE IN NORMAL RENAL FUNCTION <\/H3>200\u2013400 mg once daily

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :531.4<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :>90<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 13<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :0.36<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :2\/3.3

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in normal renal function
  • HDF\/high flux &nbsp :Unknown dialysability. Dose as in normal renal function
  • CAV\/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Analgesics: inhibits buprenorphine metabolism \u2013 reduce buprenorphine dose\n
  • Anti-arrhythmics: increased risk of ventricular arrhythmias with disopyramide \u2013 avoid concomitant use\n
  • Antibacterials: metabolism increased by rifampicin; may reduce rifampicin concentration; concentration possibly reduced by isoniazid; avoid concomitant use with telithromycin in severe renal and hepatic impairment\n
  • Anticoagulants: anticoagulant effect of coumarins enhanced\n
  • Antidepressants: avoid concomitant use with reboxetine; ketoconazole increases concentration of mirtazepine\n
  • Anti-epileptics: concentration of ketoconazole reduced by phenytoin; concentration of carbamazepine possibly increasedAntihistamines: concentration of loratidine possibly increased; avoid concomitant use with mizolastine\n
  • Antimalarials: manufacturer advises avoid artemether and lumefantrine with ketoconazole\n
  • Antipsychotics: increased risk of ventricular arrhythmias with pimozide \u2013 avoid concomitant use; possibly increased concentration of quetiapine \u2013 reduce quetiapine dose; increased risk of ventricular arrhythmias with sertindole \u2013 avoid concomitant use; inhibits aripiprazole metabolism \u2013 reduce aripiprazole dose\n
  • Antivirals: concentration of both drugs increased with darunavir; inhibits metabolism of indinavir; concentration reduced by nevirapine \u2013 avoid concomitant use; ketoconazole and ritonavir can increase concentration of each other; concentration of saquinavir increased; concentration increased by amprenavirAnxiolytics and hypnotics: concentration of alprazolam and midazolam increased (risk of prolonged sedation)\n
  • Calcium-channel blockers: increased concentration of felodipine; avoid with lercanidipine and nisoldipine; possibly inhibits metabolism of dihydropyridines\n
  • Ciclosporin: increased ciclosporin concentrationCilostazol: possibly increased concentration of cilostazol, avoid concomitant useCinacalcet: increased cinacalcet concentration\n
  • Diuretics: increased eplerenone concentration \u2013 avoid concomitant useDomperidone: possibly increased risk of arrhythmias\n
  • Ergot alkaloids: increased risk of ergotism with ergotamine and methysergide \u2013 avoid concomitant use5HT 1 agonists: increased concentration of eletriptan \u2013 avoid concomitant use; increased almotriptan concentration (increased toxicity).KEToConAZoLE 407Ivabradine: concentration of ivabradine increased \u2013 avoid concomitant useLanthanum: reduces absorption of ketoconazole \u2013 give at least 2 hours apartSirolimus: concentration increased by ketoconazole \u2013 avoid concomitant useStatins: possibly increased risk of myopathy with atorvastatin and simvastatin \u2013 avoid concomitant use with simvastatin\n
  • Tacrolimus: increased tacrolimus concentrationTheophylline; possibly increased concentration of theophylline\n
  • Vardenafil: increased concentration of vardenafil, avoid concomitant use

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>Oral, topical

    Rate of Administration <\/H4>\u2013

    Comments<\/H4>\u2013

    OTHER INFORMATION <\/H4>Monitor LFTs especially if on long-term treatment.
    \n","protected":false},"excerpt":{"rendered":"

    Ketoconazole CLINICAL USE Antifungal agent DOSE IN NORMAL RENAL FUNCTION<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4099","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4099","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4099"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4099\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4099"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4099"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4099"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}