General Description: Ketoconazole is an antifungal agent used to treat fungal infections (ex. ringworm, bone, lung, central nervous system infections). It may also be prescribed for Cushing’s disease or for other reasons. Give ketoconazole with a fatty meal to reduce stomach upset and increase absorption. This medication is available as a tablet or in various topical preparations.

What is this drug?

Given by mouth; some forms are used topically
Reasons for prescribing:

Treatment of fungal infections, whether limited to the skin (ex. ringworm, Malassezia dermatitis), or more serious infections affecting organ systems (bone, lungs, nervous system)
Treatment of Cushing’s disease
Sometimes used at the same time as the expensive drug Cyclosporine. Ketoconazole reduces the amount of cyclosporine needed.
What dogs/cats should not take this medication?

Some believe ketoconazole should not be used in cats
Pets known to have had an allergic reaction to ketoconazole or like products before
Pets with liver disease or clotting disorders
Breeding, pregnant or nursing animals

To reduce the incidence of stomach upset, divide the dose and give with meals.

Give medication as directed by your veterinarian. Depending upon the condition, this medication may be given once, twice or three times daily. Your veterinarian may suggest tablets be given with a fatty food (ex. butter or cheese).

Give the exact amount prescribed and only as often as directed. Missed doses reduce the effectiveness of therapy. Ideally, give the medication at the same time daily.

Call ahead for refills. Long term-therapy (from a few weeks up until a year) is usually necessary for successful results.

If for some reason your pet needs antacids while on ketoconazole, give them two hours after ketoconazole is administered.

It may take one or two weeks before effects of the medication are noted.

What if dose is missed?

If a dose is missed, give it as soon as you can. If it is time already for the next dose, skip the missed dose and go back to the normal schedule. Do not give two doses at the same time.

What to tell/ask veterinarian before giving medication?

Talk to your veterinarian about:

When will your pet need to be rechecked
What tests may need to be performed prior to and during treatment with this drug
Risks and benefits of using this drug
Tell your veterinarian about:

If your pet has experienced side-effects on other drugs/products
If your pet has experienced digestive upset now or ever
If your pet has experienced liver or kidney disease now or ever
If your pet has experienced any other medical problems or allergies now or ever
All medicines and supplements that you are giving your pet or plan to give your pet, including those you can get without a prescription. Your veterinarian may want to check that all of your pet’s medicines can be given together.
If your pet is pregnant or nursing or if you plan to breed your pet
Storage and Warnings:

Store in a tight, light resistant, childproof container in a cool, dry place at room temperature away from heat and direct sunlight.

When administering the topical cream, the owner should wear gloves and wash hands after use.

Keep this and all medication out of reach of children and pets. Call your physician immediately if you accidentally take this product.

Potential side effects:

Nausea, decrease in appetite, vomiting, diarrhea (especially cats)
High doses may cause liver disease (jaundice – yellowing of gums, skin or eyes), but are resolved when medication is discontinued. This has been found more often in cats and some dogs. Monitoring liver enzymes and blood counts during long-term therapy is advised.
Some individuals will have a lightened hair coat while undergoing therapy. Reverses when medication is discontinued.
May cause bleeding problems
Some individuals may need prednisone administered along with ketoconazole
Testicular secretion of testosterone is reduced; may produce a feminizing effect or infertility in males.
If you notice anything unusual, contact your veterinarian
Can this drug be given with other drugs?

Yes, but possible interactions may occur with acyclovir, antacids, anticholinergics (ex. propantheline), cyclosporine, digoxin, ethanol, H 2blockers (cimetidine, ranitidine), isoniazid, mitotane, methylprednisolone, phenytoin, rifampin, theophylline and warfarin.
These drugs should not be given with ketoconazole: astemizole, cisapride and terfenadine.
If your pet experiences any unusual reactions when taking multiple medications, contact your veterinarian.

Contact your veterinarian immediately if pet eats more than the prescribed amount.

What else should I know?

Notify your veterinarian if your animal’s condition does not improve or worsens despite this treatment.

As with all prescribed medicines, ketoconazole should only be given to the dog/cat for which it was prescribed. It should be given only for the condition for which it was prescribed.

This is just a summary of information about ketoconazole. If you have any questions or concerns about ketoconazole or for the condition it was prescribed, contact your veterinarian.

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