Exotis ISSN 2398-2985

Reptiles

Ketoconazole

Contributor(s): Vetstream Ltd, David Perpinan

Introduction

Name

  • Ketoconazole.

Class of drug

  • Imidazole antifungal agent.

Description

Chemical name

  • 1-[4-[4-[[(2R,4S)-2-(2,4-dichlorophenyl)-2-(imidazol-1-ylmethyl)-1,3-dioxolan-4-yl]methoxy]phenyl]piperazin-1-yl]ethanone.

Molecular formula

  • C26H28Cl2N4O4.

Molecular weight

  • 531.43.

Physical properties

  • Colorless crystals or powder.
  • White to slightly beige powder.
  • Practically insoluble in water.

Storage requirements

  • Store at room temperature in a dry place away from moisture.

Uses

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Indications

  • Used to treat aspergillosis, candidiasis, blastomycoses, coccidiomycoses, cryptococcosis, sporotrichosis and dermatophytosis.
  • Uncommonly used nowadays.
  • Its use has been replaced by newer antifungals with decreased toxicity and increased efficacy, such as itraconazole [Itraconazole] or fluconazole Fluconazole.

Administration

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Pharmacokinetics

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Precautions

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Interactions

with other drugs

  • Drugs increasing pH of gastric contents, eg antacids, antimuscarinics and H2 blockers
  • The absorption of ketoconazole may be impaired; stagger dosing of these drugs around ketoconazole dose.
Methylprednisolone
  • Ketoconazole extends the activity of methylprednisolone.
Phenytoin
  • Plasma ketoconazole levels are reduced by phenytoin.
Antihistamines, oral hypoglycemics, antiepileptics, cisapride and ciclosporin
  • Antifungal imidazoles and triazoles inhibit metabolism of these drugs but interactions have not been studied in veterinary field.

Adverse Reactions

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Abarca M L, Martorell J, Castella G et al (2009) Dermatomycosis in a pet inland bearded dragon (Pogona vitticeps) caused by a Chrysosporium species related to Nannizziopsis vriesii. Vet Derm 20 (4), 295-299 PubMed.
  • Page C D, Mautino M, Derendorf H et al (1991) Multiple-dose pharmacokinetics of ketoconazole administered orally to gopher tortoises (Gopherus polyphemus). J Zoo Wildl Med 22 (2), 191-198 VetMedResource.

Other sources of information

  • Plumb D C (2015) Plumb's Veterinary Drug Handbook. 8th edn. Wiley-Blackwell, USA. pp 1296.
  • Mader D R (2006) Ed Reptile Medicine and Surgery. Saunders Elsevier, USA. pp 1242.
  • McArthur S, Wilkinson R & Meyer J (2004) Medicine and Surgery of Tortoises and Turtles. Blackwell Publishing, UK. pp 579.
  • Tennant B (1999) Small Animal Formulary. 3rd edn. BSAVA, UK.

Organisation(s)

  • National Office of Animal Health (NOAH) Compendium of Data Sheets for Animal Medicines. Website: www.noahcompendium.co.uk.

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