케토코나졸
별칭: Nizoral, Fungiconazole
약물 분류: Azole Antifungal
- **투여 방법:** 흡수를 높이고 위장 장애를 줄이기 위해 이 약을 음식과 함께 먹이세요. 반려동물이 구토를 하거나 식욕을 잃는 경우, 하루 복용량을 나누어 먹이는 것이 도움이 될 수 있습니다. - **부작용:** 식욕 부진, 구토 또는 설사가 있는지 관찰하세요. 이러한 증상이 나타나면 수의사에게 연락하세요. 고양이의 경우 이러한 부작용이 더 흔하게 나타납니다. - **털 변화:** 치료 기간 동안 반려동물의 털 색깔이 옅어지는 것을 발견할 수 있으나, 이는 약을 끊으면 회복됩니다. - **치료 기간:** 진균 감염은 보통 수개월의 지속적인 치료가 필요합니다. 반려동물의 상태가 좋아진 것 같더라도 감염이 쉽게 재발할 수 있으므로 일찍 약을 중단하지 마세요. - **경고:** 케토코나졸은 많은 약물과 상호작용하므로, 반려동물이 복용 중인 *모든* 다른 약물에 대해 수의사에게 알려주세요.
용량은 반려동물의 상태에 따라 수의사가 결정합니다. 수의사의 지도 없이 인간용 의약품이나 다른 반려동물의 처방약을 투여하지 마세요.
Veterinary professional? See the full dosing-by-species reference on VetSheet →
용도
- 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)
- Susceptible infections (Rabbits)
- Systemic mycoses/candidiasis (Hamsters, Gerbils, Mice, Rats, Guinea pigs, Chinchillas)
- Coccidioidomycosis (systemic form)
- Coccidioidomycosis (CNS form)
- Coccidioidomycosis (bony lesions or relapses)
- Coccidioidomycosis
- Blastomycosis
- Blastomycosis
- Histoplasmosis
- Histoplasmosis
- Aspergillosis
- Nasal aspergillosis
- Cryptococcosis
- Fungal myocarditis
- Candidiasis
- Sporotrichosis
- Malassezia dermatitis (severe)
- Malassezia dermatitis
- Malassezia dermatitis
- Malassezia dermatitis
- Malassezia dermatitis
- Hyperadrenocorticism
- Hyperadrenocorticism
- Hyperadrenocorticism (palliative)
- Reduce cyclosporine dosage
- Perianal fistula (with cyclosporine)
- Atopic dermatitis (with cyclosporine)
- IMHA (with cyclosporine)
- Susceptible infections (most species)
- Fungal shell diseases in turtles/tortoises
투여 방법
POTopical
가능한 부작용
- 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)
- Teratogenic effects
주의사항 및 금기
- 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.
약물 상호작용
- 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)
- Digoxin: Ketoconazole may increase digoxin levels
- Fentanyl/Alfentanil: Ketoconazole may increase fentanyl or alfentanil levels
- H2-blockers (ranitidine, famotidine): Increased gastric pH may reduce ketoconazole absorption
- Hepatotoxic drugs: Should be used cautiously together due to additive hepatotoxicity risk
- Isoniazid: May affect ketoconazole levels; concomitant use not recommended
- Ivermectin: Ketoconazole may increase risk for neurotoxicity; should never be used together in dogs
- Macrolide antibiotics (erythromycin, clarithromycin): May increase ketoconazole concentrations
- Mitotane: Not recommended together; adrenolytic effects of mitotane may be inhibited by ketoconazole
- Phenytoin: May decrease ketoconazole levels
- Proton-pump inhibitors (omeprazole): Increased gastric pH may reduce ketoconazole absorption
- Quinidine: Ketoconazole may increase quinidine levels
- Rifampin: May decrease ketoconazole levels; ketoconazole may increase rifampin levels
- Sucralfate: May reduce absorption of ketoconazole
- Sulfonylurea antidiabetic agents (glipizide, glyburide): Ketoconazole may increase levels; hypoglycemia possible
- Theophylline: Ketoconazole may decrease serum theophylline concentrations; monitor levels
- Vincristine/Vinblastine: Ketoconazole may inhibit vinca alkaloid metabolism and increase levels
- Warfarin: Ketoconazole may cause increased prothrombin times
- Ciclosporin: Ketoconazole increases blood levels of ciclosporin (used therapeutically to reduce ciclosporin dose requirements)
- Amphotericin B: Used synergistically in systemic fungal disease, allowing for a reduced dose of amphotericin B
- Proton-pump inhibitors (PPIs): Increases gastric pH, which impairs the absorption of ketoconazole; stagger dosing
- H2 blockers: Increases gastric pH, which impairs the absorption of ketoconazole; stagger dosing
- Antimuscarinics: Increases gastric pH, which impairs the absorption of ketoconazole; stagger dosing
- Methylprednisolone: Ketoconazole extends the activity of methylprednisolone
- Antihistamines: Inhibits the metabolism of antihistamines (extrapolated from human data)
- Oral hypoglycaemics: Inhibits the metabolism of oral hypoglycaemics (extrapolated from human data)
- Antiepileptics: Inhibits the metabolism of antiepileptics (extrapolated from human data)
자주 묻는 질문
케토코나졸은 반려동물에게 어떻게 사용되나요?
- 투여 방법: 흡수를 높이고 위장 장애를 줄이기 위해 이 약을 음식과 함께 먹이세요. 반려동물이 구토를 하거나 식욕을 잃는 경우, 하루 복용량을 나누어 먹이는 것이 도움이 될 수 있습니다. - 부작용: 식욕 부진, 구토 또는 설사가 있는지 관찰하세요. 이러한 증상이 나타나면 수의사에게 연락하세요. 고양이의 경우 이러한 부작용이 더 흔하게 나타납니다. - 털 변화: 치료 기간 동안 반려동물의 털 색깔이 옅어지는 것을 발견할 수 있으나, 이는 약을 끊으면 회복됩니다. - 치료 기간: 진균 감염은 보통 수개월의 지속적인 치료가 필요합니다. 반려동물의 상태가 좋아진 것 같더라도 감염이 쉽게 재발할 수 있으므로 일찍 약을 중단하지 마세요. - 경고: 케토코나졸은 많은 약물과 상호작용하므로, 반려동물이 복용 중인 *모든* 다른 약물에 대해 수의사에게 알려주세요.
케토코나졸은 우리 반려동물에게 안전한가요?
용량은 반려동물의 상태에 따라 수의사가 결정합니다. 수의사의 지도 없이 인간용 의약품이나 다른 반려동물의 처방약을 투여하지 마세요.
본 글은 일반적인 건강 교육을 목적으로 하며 전문적인 수의학적 조언을 대신할 수 없습니다. 반려동물이 아프면 수의사와 상담하세요.