Drug	Typical Dosing

Ketoconazole Nizoral^® Generics available Pregnancy: C; Lactation: Unsafe Tabs: 200 mg Cream 2%: (15, 30, 60 g) Shampoo 2%

Children ≥2 years: 3.3-6.6 mg/kg once daily (max 400 mg/day). 200 mg @ 4-5 mg/kg daily 25 lb (11 kg) = ^1/4 tab Q24H 50 lb (22 kg) = ^1/2 tab (2.5 mL) Q24H 75 lb (33 kg) = ^3/4 tab (7.5 mL) Q24H 100 lb (45 kg) = 1 tab (5 mL) Q24H Adult: 200-400 mg PO once daily. Shampoo: Dampen affected area and apply shampoo. Rinse thoroughly after 1 minute. Repeat 2 times a week. Cream: Apply to affected area once or twice daily. Food: May take without regard to food. May take with food if GI upset occurs. Avoid taking within 2 hours of acid-suppressing drugs. Important side effects: Headache, dizziness, nausea, vomiting, hepatotoxicity, rash, urticaria, pruritus, reduced testosterone levels, gynecomastia. Advise patient to report any prodromal signs of liver failure (fatigue, weakness, nausea, vomiting, yellowing of eye(s) or skin). Shampoo may take curl out of permanently styled hair. Caution: Has been associated with fatal hepatotoxicity; monitor liver function closely. Drug interactions may be significant, including: Antacids, didanosine, tricyclic antidepressants, carbamazepine, proton pump inhibitors, H2 blocking agents, quinidine, benzodiazepines, buspirone, sulfonylureas, oral contraceptives, donepezil, tacrolimus, cyclosporine, isoniazid, warfarin, corticosteroids, rifampin, theophylline. Efficacy of oral contraceptives may be reduced, and ketoconazole has caused birth defects in animals. Advise women of child-bearing potential to use effective alternative birth control.