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Before using this medication, please take note of the following important safety information regarding potential risks. It is crucial to discuss any concerns with your healthcare provider.

• Allergic Reactions: Be aware that some ketoconazole creams contain sulfites, which may trigger serious allergic reactions, especially in individuals with asthma or known sulfite allergies. It is important to distinguish that sulfites and sulfa are different, and many individuals with sulfa allergies can tolerate medications with sulfites. If you have a known allergy to sulfites, inform your healthcare provider prior to using ketoconazole cream. Seek immediate medical assistance if you experience symptoms like hives, swelling of the lips or tongue, or difficulty breathing after application, as these may indicate a severe allergic reaction.

• Contraindications: No specific contraindications have been identified for this medication.

Remember to always consult with your healthcare professional for personalized advice and to ensure safe use of the medication.

Common side effects:

• Itching
• Skin irritation
• Stinging

Less common but important to monitor:

• Rash at the application site

Serious side effects:

• Blistering
• Open sores
• Severe allergic reaction characterized by hives
• Swelling of the face, tongue, or throat
• Severe dizziness
• Difficulty breathing

Ketoconazole, an antifungal medication, can interact with various other drugs, potentially leading to serious health risks. It's crucial to be aware of these interactions to ensure safe and effective treatment.

Medications That Should Not Be Combined with Ketoconazole:

• Certain Heart Medications: Combining ketoconazole with drugs like Dofetilide, quinidine, and dronedarone can lead to dangerous heart rhythm problems, including QT prolongation, which may result in life-threatening irregular heartbeats.

• Methadone: Using methadone alongside ketoconazole increases the risk of QT prolongation, potentially causing severe heart rhythm issues.

• Ranolazine: This combination can also lead to QT prolongation, posing significant heart-related risks.

• Cholesterol-Lowering Statins: Ketoconazole can elevate levels of statins like Simvastatin and Lovastatin, increasing the risk of muscle problems, including a serious condition called rhabdomyolysis.

• Certain Sedatives: Medications such as Triazolam, Midazolam, and Alprazolam may have prolonged sedative effects when taken with ketoconazole, leading to excessive drowsiness.

• Eplerenone: Combining this drug with ketoconazole can result in low blood pressure and decreased potassium levels.

Medications That May Require Caution or Dosage Adjustments:

• Pain Relievers: Drugs like Buprenorphine, Fentanyl, and Oxycodone may cause slowed breathing when used with ketoconazole.

• Blood Thinners: Anticoagulants such as Rivaroxaban, Dabigatran, and Warfarin can have an increased risk of bleeding when taken with ketoconazole.

• Blood Pressure Medications: Drugs like felodipine and nisoldipine may lead to swelling and heart failure when combined with ketoconazole.

• Tamsulosin: This combination can cause headaches, dizziness, and low blood pressure upon standing.

• Digoxin: Elevated levels of digoxin may occur, leading to dizziness, headaches, and stomach pain.

• Eletriptan: Using this migraine medication with ketoconazole can result in weakness, nausea, dizziness, and drowsiness.

• Antipsychotics: Drugs like Aripiprazole, Buspirone, Haloperidol, Quetiapine, and Risperidone may cause dizziness, drowsiness, and headaches when taken with ketoconazole.

• Ramelteon: This sleep aid may lead to increased dizziness, drowsiness, and fatigue when combined with ketoconazole.

• Antivirals: Medications such as indinavir, Maraviroc, and saquinavir can cause stomach pain, nausea, and headaches when used with ketoconazole.

• Other Blood Pressure Medications: Drugs like Verapamil and Aliskiren may result in low blood pressure, low heart rate, and dizziness when combined with ketoconazole.

• Erectile Dysfunction Medications: Drugs such as Sildenafil, Tadalafil, and Vardenafil may cause headaches, upset stomach, and muscle pain when taken with ketoconazole.

• Urinary Problem Medications: Drugs like Solifenacin and Tolterodine may lead to dry mouth, headaches, and dizziness when combined with ketoconazole.

Medications That May Reduce Ketoconazole's Effectiveness:

• Stomach Acid Reducers: Medications like Famotidine, Cimetidine, Pantoprazole, Omeprazole, and Rabeprazole can decrease ketoconazole absorption. It's recommended to take ketoconazole with an acidic beverage, such as non-diet cola, if using these drugs.

• Antacids: Drugs like aluminum hydroxide should be taken at least 1 hour before or 2 hours after ketoconazole to avoid reduced absorption.

• Certain Antibiotics: Medications such as Isoniazid and Rifabutin may decrease ketoconazole levels, reducing its effectiveness.

• Anticonvulsants: Drugs like Carbamazepine and Phenytoin can lower ketoconazole levels, making it less effective.

• Antivirals: Medications such as Efavirenz and Nevirapine may decrease ketoconazole's effectiveness.

Important Considerations:

• Alcohol: Avoid consuming alcohol while taking ketoconazole, as it can increase the risk of liver damage.

• Grapefruit Juice: Steer clear of grapefruit or grapefruit juice, as it can raise ketoconazole levels in your blood, heightening the risk of side effects.

Always inform your healthcare provider about all medications, supplements, and herbal products you are currently using before starting ketoconazole. This will help prevent potential interactions and ensure your treatment is both safe and effective.