Talk:Ketoconazole

fungistatic / fungicidal
Is this primarily fungistatic or fungicidal? I have found information indicating that this might be fungicidal, whereas fluconazole is primarily fungistatic. If anyone has further information, please add it. I have Valley Fever, and this could save my life. Thanks.

I did my doctorate on resistance to ketoconazole and fluconazole - back when they were just experimental samples from Jannsen and Pfizer. Certainly ketoconazole seemed more toxic than fluconazole. When resistance arose to ketoconazole one could still apply a high enough dose to suppress fungal growth. In the case of fluconazole there was simply no amount of fluconazole that could be added to stop growth. Whether they were fungicidal or fungistatic is a tricky question as it depends on the fungal species and stage of growth. I believe in general that ketoconazole was more lethal as it was less specific and had effects on targets other than 14-alpha demethylase. I would suggest that amphotericin B and other polyene antifungals are considered more fungicidal than the azole family, though of course they are associated with more serious potential side effects. Phil Scrutinator (talk) 19:57, 15 March 2008 (UTC)

baldness
I have to admit, I had no idea Ketoconazole could treat baldness. I looked it up though and it seems to be true, though to what extent I'm not sure. I didn't want to edit the article itself, but here are a couple of references:

Journal of Dermatological Science Volume 45, Issue 1, January 2007, Page 66, Reversal of androgenetic alopecia by topical ketoconzole: Relevance of anti-androgenic activity, Shigeki Inui,and Satoshi Itami.

The Journal of Dermatology, 2002 Aug, 29(8):489-98, Comparative efficacy of various treatment regimens for androgenetic alopecia in men, Khandpur, Sujay; Suman, Mansi; Reddy, Belum Sivanagi.

And this one discusses possible mechanisms: Medical hypotheses, 2004, 62(1):112-5, Ketocazole as an adjunct to finasteride in the treatment of androgenetic alopecia in men, Hugo Perez, B S,

How about that?

Structure of Ketoconazole
Ketoconazole is a mixture of RS and SR compounds. It is registered as a "cis" compound, so a mixture, not a specific isomer. How would you like to show this? —Preceding unsigned comment added by ChemSpiderMan (talk • contribs) 16:14, 19 October 2008 (UTC)

5 Alpha Reductase Inhibitor?
I heard that Ketoconazole is a 5 Alpha Reductase inhibitor.

Is this true? And if so, how would it compare (in effectiveness at inhibiting 5 Alpha Reductase) to Finasteride and Duasteride? Pine (talk) 21:23, 14 April 2010 (UTC)
 * Ketoconazole is an antifungal rather than a 5AR inhibitor. This book has a list of all the 5AR inhibitors.--Pondle (talk) 21:49, 14 April 2010 (UTC)


 * Ketoconazol is not a 5a-reductase inhibitor, as it is not mentioned as such in the scientific press. Instead it was tested inactive against human 5a-reductase: http://www.ncbi.nlm.nih.gov/pubmed/9731491
 * Thus the passage in the main article (that Ketoconazol would block the formation of DHT in the cell) should be rewritten or deleted, as there is no source for that statement. -krx — Preceding unsigned comment added by 188.105.107.20 (talk) 21:26, 18 February 2014 (UTC)

sediBold text
kish dasht me dit si perdoret —Preceding unsigned comment added by 82.114.66.222 (talk) 13:19, 17 April 2010 (UTC)

first line
what does the first line mean "skin AND fungal infections" ? —Preceding unsigned comment added by 78.133.29.242 (talk) 14:14, 22 April 2011 (UTC)

Why is there no side effect information in this article?
There should be information on side effects and overdosing.99.56.163.129 (talk) 06:54, 29 May 2011 (UTC)

Alcohol
I'm surprised to see no mention about Ketoconazole's potential to cause liver damage, especially when consumed with alcohol. Ketoconazole also seems to have interactions and contradictions with a number of common medications. — Preceding unsigned comment added by 67.193.72.37 (talk) 04:50, 9 August 2011 (UTC)

Drug Interactions
Since Ketoconazole is interfering with cytochrome p450 there are drug interactions with this medication that should be addressed on this page. — Preceding unsigned comment added by 76.247.118.130 (talk) 23:51, 3 November 2011 (UTC)

Pharmacy ads
Please do not post pictures of commercial products when discussing non-commercial matters. (Referring to Nizoral in this case.) — Preceding unsigned comment added by 94.237.38.23 (talk) 20:56, 11 January 2012 (UTC)

Wrong structure
Ketoconazole is a mixture of two enantiomers not a single compound (pure enantiomer). The correct IUPAC name for CAS no. 65277-42-1 is 1-[4-(4-{[(2RS,4SR)-2-(2,4-dichlorophenyl)-2-(1H-imidazol-1-ylmethyl)-1,3-dioxolan-4-yl]methoxy}phenyl)piperazin-1-yl]ethan-1-one and not 1-[4-(4-{[(2R,4S)-2-(2,4-dichlorophenyl)-2-(1H-imidazol-1-ylmethyl)-1,3-dioxolan-4-yl]methoxy}phenyl)piperazin-1-yl]ethan-1-one. Both structures in the box show only one enantiomer of the racemate. 1-[4-(4-{[(2R,4S)-rel-2-(2,4-dichlorophenyl)-2-(1H-imidazol-1-ylmethyl)-1,3-dioxolan-4-yl]methoxy}phenyl)piperazin-1-yl]ethan-1-one or 1-[4-(4-{[(2R*,4S*)-2-(2,4-dichlorophenyl)-2-(1H-imidazol-1-ylmethyl)-1,3-dioxolan-4-yl]methoxy}phenyl)piperazin-1-yl]ethan-1-one would also be correct names. Best regards, --Jü (talk) 16:11, 23 July 2013 (UTC)

European Medicines Agency recommends suspension of marketing authorisations for oral ketoconazole
The European Medicines Agency’s Committee on Medicinal Products for Human Use (CHMP) has recommended that the marketing authorisations of oral ketoconazole-containing medicines should be suspended throughout the European Union (EU). The CHMP concluded that the risk of liver injury is greater than the benefits in treating fungal infections

http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Ketoconazole-containing_medicines/WC500146616.pdf 78.105.243.205 (talk) 11:00, 14 August 2013 (UTC)

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