ケトコナゾール

使用用途

• Coccidioidomycosis
• Coccidioidomycosis
• Blastomycosis
• Cryptococcosis
• Aspergillosis
• Dermatophytosis
• Sporotrichosis
• Susceptible yeasts and Aspergillus spp
• Scopulariopsis pneumonia
• Severe refractory candidiasis in Psittacines
• Susceptible fungal infections (most species)
• Susceptible fungal infections (most species)
• Susceptible fungal infections (Moluccan Cockatoos)
• Susceptible fungal infections (Ratites)

投与方法

考えられる副作用

• Anorexia (most common, especially in cats)
• Vomiting
• Diarrhea
• Hepatic toxicity (cholangiohepatitis, increased liver enzymes)
• Thrombocytopenia (rare)
• Reversible lightening of haircoat
• Transient suppression of gonadal and adrenal steroid synthesis
• Infertility in male dogs (reversible)
• Hepatotoxicity
• Anorexia
• Alterations in hair-coat colour
• Thrombocytopenia (at high doses)
• Adrenal insufficiency (at high doses)
• Cataract development (in dogs)

注意事項と禁忌

• Known hypersensitivity to ketoconazole
• Controversial/Contraindicated in cats (due to toxicity risks)
• Concurrent use with cisapride or ivermectin (in dogs)
• Hepatic insufficiency
• Pregnancy (due to possible teratogenic effects)
• Use with caution in patients with **hepatic disease** or **thrombocytopenia**. Ketoconazole is a known **teratogen and embryotoxin**; weigh risks vs. benefits in pregnant animals. It may cause reversible infertility in male dogs by decreasing testosterone synthesis. Dogs undergoing high-dose antifungal therapy may need additional glucocorticoid support during periods of acute stress due to adrenal suppression.

薬物相互作用

• Alcohol: May produce a disulfiram-like reaction (vomiting)
• Antacids: May reduce oral absorption of ketoconazole; administer at least 1 hour before or 2 hours after
• Tricyclic Antidepressants (amitriptyline, clomipramine): Ketoconazole may reduce metabolism and increase adverse effects
• Benzodiazepines (midazolam, triazolam): Ketoconazole may increase levels
• Buspirone: Plasma concentrations may be elevated
• Busulfan: Ketoconazole may increase levels
• Calcium-channel blockers (amlodipine, verapamil): Ketoconazole may increase levels
• Cisapride: Ketoconazole may increase cisapride levels and possibility for toxicity; use together contraindicated
• Corticosteroids: Ketoconazole may inhibit metabolism; potential for increased adverse effects
• Cyclophosphamide: Ketoconazole may inhibit metabolism; potential for increased toxicity
• Cyclosporine: Increased cyclosporine levels (often used therapeutically to reduce cyclosporine dose)

よくある質問