It is generally difficult to treat fungal infections. This infection often requires months of treatment, depending on how deep it is and how strong the patient’s immune system is. Some fungal infections are limited to the skin, like “Ringworm” or Malassezia dermatitis, whereas others can affect vital organs, such as the lung, bone, and even the nervous system. A superficial infection can usually be eradicated within weeks, while deeper infections can take over a year.
Used to be the only available treatment for life-threatening fungal infections was a drug called Amphotericin B, which had to be given intravenously in a fluid drip and caused a high incidence of kidney failure (some sources say up to 50%).
It was evident that a new approach to treatment was required. This innovation was ketoconazole. In addition to being free of renal side effects, ketoconazole is also given orally as a tablet, saving patients from needing expensive inpatient stays.
A number of related antifungals have been developed since ketoconazole was introduced. Itraconazole, for instance, was introduced to treat nausea side effects.
The purpose of fluconazole is to penetrate the central nervous system and treat fungus infections there. Ketoconazole and its relatives are now available in generic form, making the treatment of fungal diseases more accessible, safer, and effective.
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The most common side effects of this drug are nausea, vomiting, and diarrhea. Ketoconazole can reduce these side effects if it is given with food or if it is divided into several small doses. Severe nausea will go away when the medication is discontinued.
In certain individuals or at higher dosages, liver disease may result from administration, but should resolve after discontinuing the drug. Cats are usually affected by this condition rather than dogs, and it is either dose-dependent or independent. It is characterized by inflammation of the liver similar to cholangiohepatitis.
When ketoconazole is used, liver enzyme levels commonly increase on a blood test, but this does not necessarily indicate the development of liver reactions. It is recommended that liver enzymes be monitored during long-term ketoconazole treatment.
Ketoconazole may cause some individuals to show a lightening in the hair coat. When discontinuing this medication, this effect will return.
Males may experience a feminizing effect from ketoconazole because it interferes with testosterone secretion from the testicles.
Moreover, ketoconazole interferes with the adrenal gland’s ability to produce cortisone, which makes it useful in treating Cushing’s disease.
It is not safe to use ketoconazole during pregnancy and pregnant women should not handle it.
What This Medication Does
A fungal cell wall is interfered with by ketoconazole. Ketoconazole kills or inhibits fungi depending on the fungus and the dose used. The following fungi are commonly treated with ketoconazole: Aspergillosis, Malassezia Dermatitis, Coccidiomycosis (Valley Fever), Cryptococcosis, Histoplasmosis, and Blastomycosis, It is best to use other medications for Dermatophytosis (Ringworm).
Another side effect of ketoconazole can be used therapeutically while generally considered a side effect. Cyclosporine, an immunomodulating drug, can also be slowed by ketoconazole.
Currently, cyclosporine is a very expensive medication, so using ketoconazole to spare its use will allow for a reduction in the dose requirement, making treatment more affordable.
Ketoconazole also blocks the adrenal gland from producing cortisone. Ketoconazole can therefore be used to treat Cushing’s disease, which is characterized by the overproduction of adrenal hormones.
There is at least a 50-fold increase in the lethal dose of this medication when compared with the usual recommended dose, so serious side effects are rare (nausea and upset stomach are not uncommon).
Drugs And Other Drugs
Ketoconazole absorbs better if it is taken with acid, so it is advisable not to take ketoconazole with antacids. Another medicine used to treat stomach ulcers, sucralfate, may also interfere with ketoconazole absorption. If possible, delay ketoconazole and antacids by a couple of hours.
If cyclosporine is given along with ketoconazole, its blood levels will increase, since cyclosporine is an immune suppressant used in transplant patients and in some immune-mediated conditions. Using this pharmacological “trick,” the dose of cyclosporine can be reduced.
Examples of other medications whose blood levels may be high or whose effects are greater than usual are Methamprednisolone (a corticosteroid), glipizide (a diabetes medication), cyclophosphamide (a chemotherapy agent), ivermectin (in higher doses), vincristine (a cancer chemotherapy drug), tramadol (a painkiller), cannabinoids, opioids, antianxiety medications (clomipramine, buspirone, trazodone, benzodiazepines such as al· In addition to ketoconazole, colchicine can potentially be toxic if taken concurrently. Shar pei with fever syndrome is often affected by fungal skin disease, which is common in this breed.
Ketoconazole is more likely to cause side effects when combined with macrolide antibiotics such as azithromycin and erythromycin.
Ketoconazole and cisapride should not be taken concurrently since they can cause dangerous heart rhythm disturbances.
Concurrently taking ketoconazole and theophylline may lessen their effectiveness.
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Cautions And Concerns
Due to its feminization effect, ketoconazole is best avoided when breeding male animals. Additionally, it is best avoided in patients with preexisting liver disease or low platelet counts.
There are risks associated with ketoconazole, including birth defects.
Veterinary practitioners typically monitor liver enzymes and complete blood counts during ketoconazole therapy for months at a time. A short-term course of medication does not require such monitoring.
It is best to take ketoconazole with food since it is well absorbed.
In order for the body to properly process ketoconazole, it needs a healthy liver. When a patient has pre-existing liver disease or is harboring a diseased liver that has yet to manifest symptoms, using a medication that processes through the liver may over-tax the liver, resulting in clinical disease.
Ketoconazole can cause nausea, which is a relatively common and benign side effect. Because nausea symptoms may be difficult to interpret, it is crucial to notify your veterinarian so he or she can determine the best course of action.
AWAY FROM LIGHT AND AT ROOM TEMPERATURE.
SKIPPING A DOSE DOES NOT IMPLY DOUBLING UP ON THE NEXT DOSE.
Can ketoconazole cause liver damage?
Some patients may require liver transplantation or even die if ketoconazole causes serious liver damage. If your dog has liver disease, ketoconazole should not be used.
How long can a dog stay on ketoconazole?
Ketoconazole is usually administered for 2 to 4 weeks, depending on the type of infection being treated. If you notice that your pet’s condition is not improving, consult your veterinarian. Treatment may be changed, medications may be added or the duration of treatment may be extended.
Can ketoconazole be taken with food?
Depending on how much ketoconazole is prescribed, ketoconazole tablets can be administered up to four times per day. It is important to take ketoconazole with food to prevent stomach upset. Ketoconazole can be taken with or without food.
Topical ketoconazole is safe?
It is considered very safe to use ketoconazole cream. Side effects, however, are possible. Ketoconazole cream reacts differently to each individual dog, but the most common side effects include itching, burning, redness, and irritation of the skin where it is applied.
The contraindications of ketoconazole?
In patients with abnormal liver function, abnormal heart rhythm, prolonged QT intervals on EKGs, and those with an EKG with QT changes since birth, ketoconazole is contraindicated.
Is ketoconazole toxic to dogs?
Your dog may experience mild side effects like headaches, nausea, and vomiting when using ketoconazole. Taking this medication for an extended period of time can result in more serious side effects. The most common problem is liver damage.
As well as interacting with other drugs, ketoconazole can also cause adverse effects. The risk of serious side effects increases significantly if your dog takes this medication along with other medications.
Is ketoconazole poisonous to dogs?
Depending on the toxicity, the tests can reveal effects on the organs. Ketoconazole can cause extensive side effects when mixed with other medications. Hepatitis caused by drugs is rare but potentially deadly.
How long can a dog take ketoconazole?
The treatment typically lasts two to four weeks. Before giving your pet this medication, wash your hands.
Is ketoconazole harmful?
Ketoconazole can cause liver damage that may lead to liver transplantation or death. Diagnosis of liver damage should be done immediately if any of the following symptoms are present: nausea, vomiting, stomach pain, fever, fatigue, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).
Will ketoconazole make my dog sleepy?
A review of the medical records of 632 dogs treated with ketoconazole (2.6-33.4 mg/kg) was conducted. 14.6% (92 dogs) of the dogs had adverse effects, including vomiting (7.1%), anorexia (4.9%), lethargy (1.9%), diarrhea (1.1%), pruritus (0.6%), erythema (0.3%) and other adverse effects (2.5%).
How long does it take for ketoconazole to leave your system?
During the first 10 hours after a dose, elimination is biphasic, lasting two hours, and then lasting eight hours. Metabolites of ketoconazole are excreted through renal excretion; metabolites are metabolized by the hepatic microsomal oxidation system.
What is ketoconazole 200 mg used for in dogs?
Infections caused by fungi can be treated with ketoconazole (brand name: Nizoral®). Drugs like cyclosporine have been reduced in dosage by this drug because it affects how other drugs are metabolized.
Can I use ketoconazole 2% shampoo on my dog?
The treatment of dermatitis due to Malassezia pachydermatis generally involves using topical antifungal shampoos in conjunction with ketoconazole. Patients with chronic dermatitis may need two to four weeks of therapy. Dogs that cannot tolerate mitotane can be treated with ketoconazole for adrenal hypercorticism.
Can you use too much ketoconazole?
It may cause irritation or redness on your skin if you use too much or too often ketoconazole shampoo or cream.
What can you not mix with ketoconazole?
While you are taking ketoconazole, you should not take disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), pimozide (Orap), quinidine (Quinidex, Quinaglute), cisapride (Propulsid; no longer available in the US), methadone (Dolophine, Methadose), or ranolazine (Ranexa).
Reviews of ketoconazole
You can apply ketoconazole topically or take it orally. Ketoconazole comes in the form of tablets. The right dosage depends on such factors as the dog’s age and weight, as well as the severity of the infection. Occasionally, dogs can experience adverse reactions such as itchy skin, diarrhea, vomiting, and fever at higher doses.
Several pet owners report success with ketoconazole against yeast infections in their pets. Ketoconazole (topical route) should not be used on dry areas or open wounds, as this may cause irritation. Several pet owners have reported that after taking this medicine their dogs experienced vomiting, diarrhea, loss of appetite, and lethargy and that the symptoms lasted for a couple of days after discontinuing the drug.
The drug Ketoconazole caused my dog’s death after he started taking it as a treatment for a yeast infection. It wasn’t certain if the ketoconazole killed my dog or not, but I think it did.”
In the groin area, armpits, and legs of my 8-year-old female German Shepherd are rashes and severe itching. Her paws were so itchy that she was constantly biting at them and chewing them. She was diagnosed with a yeast infection at the vet. In addition to shampooing, antibiotics, and Ketoconazole pills, the vet prescribed.”
“In extreme cases, Ketoconazole was used as a last resort to treat yeast infections. Side effects can be serious. Her condition deteriorated, she became groggy, she had dark stools, and she started vomiting every day after being on Ketoconazole for just a few days.”
Two weeks after starting this pill, my dog died. There was nothing they could do for her because she had internal organ failure, which was causing her vomiting and lethargy, but I’m sure that it was because of this pill.”
In general, vomiting, lack of appetite, and lethargy are the most common side effects. Contact your veterinarian if any of these symptoms persist or worsen.