Ketoconazole vs Clotrimazole – detailed comparison:
Ketoconazole
It is a drug that belongs to a class of drugs called antifungals.
This medication works by slowing the growth of fungi which cause infection.
It was originally approved by the US Food and Drug Administration in 1981. It is produced by Janssen Pharmaceuticals, a pharmaceutical company with headquarters in Beerse, Belgium.
Uses
This medication is available both in a prescription and over-the-counter form.
The prescription form is used to treat serious fungal infections, which can spread to different parts of the body. The OTC form is used to treat dandruff and hair loss.
Note – it should be used only when you cannot use other antifungal medications.
Dosage
It is available as a topical cream, topical foam, oral tablet, shampoo, and topical gel. The usual recommended dose is 200 mg, taken once a day for up to 6 months.
The maximum recommended dose is 400 mg, taken once a day.
Side Effects and Precautions
Common side effects may include:
- dry mouth;
- headaches;
- nervousness;
- constipation;
- flushing;
- diarrhea;
- muscle pain;
- stomach pain;
- sensitivity to light;
- heartburn;
- chills;
- difficulty sleeping.
Rare side effects may include:
- weakness;
- problems swallowing;
- difficulty breathing;
- decreased sexual ability;
- change in the ability to taste;
- breast enlargement in men;
- nosebleeds;
- change in tongue color;
- extreme tiredness;
- hoarseness;
- swelling of the tongue, hands, feet, eyes, face, lips, ankles, or lower legs;
- hair loss;
- the burning of the hands or feet;
- hives.
Contraindications
To make sure that this medication is safe for you, tell your healthcare provider if you have:
- a personal history of long QT syndrome;
- liver problems;
- if you use certain antibiotics, migraine headache medicine, heart rhythm medication, medicines to treat depression or anti-malaria medication;
- problems with the adrenal gland.
Alcohol
You shouldn’t drink alcoholic beverages while taking this medication since alcohol use can increase your risk of side effects, especially liver damage.
Drug Interactions
It may negatively interact with other medications, especially:
- Cisapride (Propulsid);
- Disopyramide (Norpace);
- Alprazolam (Niravam);
- Dofetilide (Tikosyn);
- ergot alkaloids, like – dihydroergotamine (Migranal), ergotamine (Ergomar), and methylergonovine (Methergine);
- Dronedarone (Multaq);
- Lovastatin (Mevacor);
- Pimozide (Orap);
- Lurasidone (Latuda);
- Quinidine (Quinidex);
- Nisoldipine (Sular);
- Methadone (Dolophine);
- Triazolam (Halcion);
- Ranolazine (Ranexa);
- Tolvaptan (Samsca);
- Eplerenone (Inspra);
- Simvastatin (Zocor);
- Felodipine (Plendil);
- Midazolam (Versed);
- Irinotecan (Camptosar).
Pregnancy & Breastfeeding
It passes into breast milk and may cause side effects in a breastfed infant. Tell your healthcare provider if you are breastfeeding a baby before using this medication.
It is not known exactly whether this antifungal will harm a developing fetus. Tell your healthcare provider if you are pregnant or plan to fall pregnant while taking this antifungal.
Clotrimazole
It is a medication that belongs to a group of medications called antifungals. It is sold under the brand name Canesten, Gyne-Lotrimin, Desenex, Lotrimin AF, or Alevazol.
This medication works by interfering with the production of the membrane which surrounds fungal cells.
Uses
This antifungal is found both as an over-the-counter and a prescription form. The prescription form is used to treat yeast infections of the mouth and skin. The over-the-counter form is used to treat yeast infections of the vagina and the skin.
Dosage
It comes as a lotion, powder, a vaginal tablet, cream, and lozenge.
The lotion, cream, or solution forms are applied to the affected area two times per day. The lozenge form is commonly given 5 times a day for 12 days.
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Contraindications
- not for ophthalmic use;
- for external use only.
Side Effects and Precautions
Common side effects may include:
- burning at the site of application;
- nausea;
- redness or peeling at the site of the application.
Less common side effects may include:
- vomiting;
- stomach pain;
- fever (high temperature).
Pregnancy & Breastfeeding
This medication may negatively affect an unborn baby. Tell your healthcare professional if you are pregnant or plan to fall pregnant before using this antifungal.
This antifungal is passed through breast milk and may negatively affect the breastfed infant. Tell your healthcare professional that you are breastfeeding a baby before use.
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Drug Interactions
It may negatively interact with other medications, especially:
- Advair Diskus (fluticasone/salmeterol);
- Aspirin Low Strength (aspirin);
- Lasix (furosemide);
- Benadryl (diphenhydramine);
- Tylenol (acetaminophen);
- Symbicort (budesonide/formoterol);
- Lyrica (pregabalin);
- Cymbalta (duloxetine);
- ProAir HFA (albuterol);
- Nexium (esomeprazole);
- beclomethasone;
- MiraLax (polyethylene glycol 3350);
- metronidazole;
- Singulair (montelukast);
- Lipitor (atorvastatin);
- betamethasone;
- fluconazole;
- hydrocortisone;
- Synthroid (levothyroxine).
Alcohol
It is recommended to avoid drinking alcoholic beverages while taking this medication since alcohol intake can substantially increase the risk of side effects.
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Bottom Line – Ketoconazole vs Clotrimazole
Ketoconazole (brand names – Nizoral, Extina, Xolegel, Kuric) is an antifungal that works by stopping the growth of fungus. It is used to treat serious fungal infections when other medicines can’t be taken.
Clotrimazole (brand names – Canesten, Gyne-Lotrimin, Desenex, Lotrimin AF, or Alevazol) is an antifungal that is used to treat skin infections, such as – yeast infections, jock itch, athlete’s foot, and ringworm.
According to a 2003 study that was conducted at the Department of Dermatology, Germany, both medications are equally effective for the treatment of ringworm, jock itch (tinea cruris), and tinea pedis (Athlete’s foot).
However, ketoconazole should be used only when you cannot use other antifungal medications since it can cause serious harm to your liver.
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References https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262531/ https://www.ncbi.nlm.nih.gov/pubmed/9669136 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964684/