General Drug Information and Indications
Ketoconzole is an oral drug which is used to treat some of the more life-threatening systemic fungal infections in dogs. Although it has also been used in cats there is enough incidence of liver toxicity that there are other anti-fungal drugs that are more commonly used.
Systemic fungal infections are serious life threatening infections and may require prolonged treatment. In many cases, an animal will be treated with ketoconazole for up to a year and in some cases, a dog will remain on treatment for life. Animals that are critically ill may start their treatment in a hospital to allow a second intravenous antifungal called amphotericin B to be used with the ketoconazole. Susceptible fungi and yeast include: Blastomyces, Coccidioides, Cryptococcus, Histoplasma, Microsporum, Trichophyton, Malassezia, Candidia, Sporotichosis, Aspergillis.
Ketoconazole is also used to treat Cushing's disease in dogs. One of its pharmacologic properties is to block the production of corticosteroids by the adrenal gland. It is also used to treat dermatitis due to a superficial yeast infection. Like many other drugs in veterinary medicine, this drug is not FDA approved for use in animals and is not available from a veterinary pharmaceutical manufacturer. Instead, it is compounded by a specialty pharmacy.
How to Give this Medication
Give this medication to your pet exactly as your veterinarian prescribes. If you miss giving your pet a dose of ketoconazole, give the next dose as soon as you remember or, if it is close to the next scheduled dose, return to the regular schedule. Do not double dose to catch up.
Ketoconazole should be given with food to improve absorption. When using ketoconazole to treat one of the severe systemic fungal infections, it may take 10-14 days before a noticeable response can be seen.
When ketoconazole is used to treat dermatitis due to a yeast infection, therapeutic shampoos are generally used in addition to the ketoconazole. Treatment may last from 2 to 4 weeks.
Wash your hands after giving your pet this medication.
Side Effects
Be sure to discuss any side effects with your veterinarian immediately. Cats are more likely than dogs to experience side effects.
The most-common side effects are nausea, vomiting, and loss of appetite. These may be manageable through decreasing or dividing the dose and administering the ketoconazole with a meal.
Liver toxicity (in cats especially), decreased platelet count, and temporary lightening of the hair coat are less common side effects.
Precautions
Keep this and all drugs out of reach of children. This drug should only be given to the animal for which it was prescribed. Do not give this medication to a person.Federal law restricts this drug to use by or on the order of a licensed veterinarian.
Ketoconazole may cause birth defects or pregnancy loss. It is generally not used in pregnant or nursing animals. It also may cause temporary infertility in male dogs.
Ketoconazole should be used with extra caution and extra monitoring of liver enzymes in animals with liver problems or in those with a decreased platelet count.y.
Drug Interactions
Be sure to review with your veterinarian any medications or supplements your pet may be receiving.
There are a large number of possible drug interactions with ketoconazole. The following list includes those that have been reported or are theoretical.
Alcohol, antacids, antidepressants, benzodiazepines, buspirone, busulfan, calcium channel blockers, cisapride, corticosteroids, cyclophosphamide, cyclosporine, digoxin, fentanyl, H2 Blockers, drugs that affect liver function, isoniazid, ivermectin, macrolide antibiotics, mitotane, phenytoin, omeprazole, quinidine, rifampin, sucralfate, some anti-diabetic drugs, theophylline, vincristine, warfarin.
Overdose
If you suspect your pet or another animal was overdosed accidentally or has eaten this medication inadvertently, contact your veterinarian or the A.S.P.C.A.'s Animal Poison Control Center at 888.426.4435. Always bring the prescription container with you when you take your pet for treatment.
If you or someone else has accidentally ingested this medication call the National Capital Poison Center at 800.222.1222.
Storage
Different strengths or dosage forms of ketoconazole may have different storage requirements. Read the labeling or ask your pharmacist for the storage requirements of the prescription you receive.
