Names and pronunciation
(kee-toe-koe′na-zole) Extina, Ketoderm , Ketozole , Nizoral, Nizoral A-D, Xolegel
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Drug reference
(kee-toe-koe′na-zole) Extina, Ketoderm , Ketozole , Nizoral, Nizoral A-D, Xolegel
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Func. class.: Topical antifungal Func. class.: Nonsteroidal antiinflam- matory product (NSAID), antirheumatic, analgesic
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Chem. class.: Imidazole derivative Chem. class.: Propionic acid derivative
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ACTION: Antifungal activity results from altering cell membrane permeability ACTION: May inhibit prostaglandin synthesis; analgesic, antiinflammatory, antipyretic
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USES: Seborrheic dermatitis (immuno- compromised), tinea corporis, tinea cruris, tinea pedis, tinea versicolor, dandruff USES: Mild to moderate pain, osteoar- thritis, rheumatoid arthritis, dysmenor- rhea; OTC relief of minor aches, pains
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Do not confuse: ketoprofen/ketorolac
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CONTRAINDICATIONS: Hyper- sensitivity, sulfite allergy Precautions: Pregnancy, breastfeeding, children
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SIDE EFFECTS INTEG: Irritation, stinging, pustules, pruritus
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Black Box Warning: CABG, GI bleeding/ perforation, thromboembolism
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DOSAGE AND ROUTES Seborrheic dermatitis • Adult/child ≥12 yr: TOP FOAM apply to affected areas bid × 4 wk; GEL apply to affected areas daily × 2 wk Tinea corporis, tinea cruris, tinea pedis, tinea versicolor • Adult: TOP cover areas daily × 2 wk Dandruff • Adult: SHAMPOO wet hair, lather, mas- sage for 1 min, rinse, repeat 2×/wk spaced by 3 days, for up to 8 wk, then as needed DOSAGE AND ROUTES Analgesic • Adult: PO 25-50 mg q6-8hr, max 300 mg/day Rheumatoid arthitis, osteoarthritis • Adult: PO 50 mg qid or 75 mg tid, max 300 mg/day or EXT REL up to 200 mg/day Dysmenorrhea • Adult: PO 25-50 mg q6-8hr (immedi- ate release) up to max 300 mg/day Ankylosing spondylitis (unlabeled) • Adults: PO 100 bid Renal/hepatic dose • Adult: PO GFR <25 mL/min/1.73m2, albumin <3.5 g/dL, decreased hepatic function, or ESRD, max 100 mg/day
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Available forms: Topical gel, foam, cream 2%; shampoo 1%, 2% Available forms: Caps 25, 50, 75, 100 mg; ext rel cap 200 mg
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Administer: Topical route • For external use only; do not use skin products near the eyes, nose, or mouth, wash hands before and after use • Cream/lotion: Apply to the cleansed affected area, massage gently into af- fected areas, do not use on skin that is broken or irritated
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Evaluate: • Therapeutic response: decreased itch- ing, scaling
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CLINICAL CONSIDERATIONS Assess allergic reaction: • Assess for hypersensitivity; product may need to be discontinued • Assess for sulfite allergy; may be life- threatening
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Patient and caregiver information: Topical route • These products are not for intravagi- nal therapy, external use only; do not use skin products near the eyes, nose, or mouth; wash hands before and after use; do not wash affected area for ≥3 hr after application • Cream/ointment/lotion: apply a thin film to the cleansed affected area, mas- sage gently • Foam formulations: do not dispense foam directly onto hands or face; dis- pense directly into the cap or onto a cool surface; cover the affected area(s); to apply, pick up small amounts of the foam with the fingertips and gently massage into the affected areas • To continue for prescribed time, tinea corporis/cruris ≥2 wk (ke-toe-proe′fen) Apo-Keto
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• Adult/child ≥12 yr: TOP FOAM apply to affected areas bid × 4 wk; GEL apply to affected areas daily × 2 wk Tinea corporis, tinea cruris, tinea pedis, tinea versicolor
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• Adult: TOP cover areas daily × 2 wk Dandruff
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• Adult: SHAMPOO wet hair, lather, mas- sage for 1 min, rinse, repeat 2×/wk spaced by 3 days, for up to 8 wk, then as needed DOSAGE AND ROUTES Analgesic
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• Adult: PO 25-50 mg q6-8hr, max 300 mg/day Rheumatoid arthitis, osteoarthritis
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• Adult: PO 50 mg qid or 75 mg tid, max 300 mg/day or EXT REL up to 200 mg/day Dysmenorrhea
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• Adult: PO 25-50 mg q6-8hr (immedi- ate release) up to max 300 mg/day Ankylosing spondylitis (unlabeled)
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• Adults: PO 100 bid Renal/hepatic dose
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• Adult: PO GFR <25 mL/min/1.73m2, albumin <3.5 g/dL, decreased hepatic function, or ESRD, max 100 mg/day
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