Medication: Ketoconazole

Your dog has been prescribed ketoconazole for the treatment of a fungal infection.

Key points:
• Antifungal.
• Cats are more susceptible to the adverse effects of ketoconazole, so this drug is rarely used in this species.
• ​Contraindicated for use in pregnant animals, animals with liver disease and in breeding males.
• Should not be handled by pregnant women.
• Treatment should be in conjunction with environmental disinfection and good hygiene.
• Concurrent treatment with a topical antifungal treatment may also be required.
• Tablets may be very palatable and so should be stored away from pets, as they may think they are treats.
• Animals treated with topical sprays should be prevented from licking the medicated area and other pets should also be prevented from licking the treated animal. Treated pets should not be allowed contact with children and should not share beds with their owners.
• Dosage: varies between routes of administration and indications. Follow your veterinarian’s directions. 

This information sheet is designed to help answer commonly asked questions and help you give the medication safely and effectively to your pet. It does not contain all available information for this medication. If you have other questions or need more information, contact your veterinarian or pharmacist.  Always follow the dosing instructions provided by your veterinarian. 

Name

• Ketoconazole (keet-oh-kon-a-zole).

Brand name

• Fungiconazol® Tablets.
• Gefriderm® cutaneous spray solution for dogs (contains ketoconazole, but also marbofloxacin and prednisolone).

Class of medication

• Antifungal.

Storage

• Store capsules, tablets and dermal sprays at room temperature protected from moisture.

Your veterinarian has prescribed ketoconazole for the treatment of a fungal infection, such as:

• Aspergillosis
• Candidiasis
• Blastomycosis
• Coccidiomycosis
• Cryptococcosis
• Sporotrichosis
• Malassezia dermatitis
• Ringworm (dermatophytosis).

Ketoconazole may occasionally be used as an adjunct to therapy to treat Cushing’s disease, but this use is off-license and its efficacy when used for this purpose is variable.

Ketoconazole tablets should be given orally with food or after a meal. Topical ketoconazole products should be administered as instructed by your veterinarian. Topical ketoconazole products must not be given orally. Preparations vary and dosing frequency will be advised by your veterinarian.

Dermal preparations are sprayed onto the skin as directed by your veterinary surgeon. Impermeable, single-use gloves should be worn and package safety instructions followed carefully.

Anorexia (reduced appetite), nausea, vomiting and alterations in hair/fur color are possible side-effects of ketoconazole and should be reported to your veterinary surgeon. Your pet may be able to continue with the drug if side-effects are mild, but it’s best to let your veterinarian know as soon as possible, so that they can decide whether additional medications or different medications are required. Very rarely, neurological symptoms or more serious side-effects may occur. Call your veterinarian if you have concerns.

Giving ketoconazole with food increases the absorption of this drug from the gastrointestinal tract.

Ketoconazole may suppress testosterone and increase progesterone levels and affect breeding effectiveness in male dogs during and for some weeks after treatment.

Ketoconazole interacts with many drugs. Tell your veterinarian about any other drugs or supplements that you are giving your dog. Antacid medications may decrease the effectiveness of ketoconazole. Methylprednisolone activity is extended if ketoconazole is administered concurrently. If your pet is on any of the following medications then their dose of these drugs may need reduced whilst on ketoconazole: antihistamines, oral diabetes drugs, epilepsy drugs, cisapride, cancer medications, and cyclosporine.

Ketoconazole should be administered according to your veterinarian’s instructions. The treatment course may extend for several months, and length of treatment will depend on clinical improvement, laboratory tests, and skin swab culture results.

Dispose of any unused ketoconazole safely – do not flush down the toilet or sink. Ask your veterinary team if they take back medication for disposal. Do not save ketoconazole for future use or give to other pets.

If you miss a dose, give the dose as soon as possible but do not give a double dose. Make sure the dose given does not exceed the total recommended dose in any 24-hour period. 

If your pet is unwell, contact your veterinarian for advice.

Ketoconazole should only be given to the dog that it has been prescribed for. If accidentally given to other pets, contact your veterinarian for advice.

• Ketoconazole should not be used in pregnant animals.
• Do not use in breeding males.
• Do not use in animals that have previously had an allergic reaction to ketoconazole.
• Do not use in animals with liver disease.

If accidentally consumed by a human, speak to your primary care physician or poison control center.

Your veterinarian will need to regularly check your pet during treatment, including repeated skin swabs for fungal culture. Your veterinarian may request blood and urine tests during treatment. In particular your veterinarian will be monitoring your pet’s liver function whilst on this medication.

Further information 

If you have any concerns, further information on ketoconazole can be found on the package inserts or via the links listed below:

Europe & UK

• Dechra (UK) Fungiconazol Tablets for Dogs. Website: www.noahcompendium.co.uk/?id=-476390&fromsearch=true#iosfirsthighlight
• Le Vet Beheer B.V. Fungiconazol tablets for dogs. Website: www.vmd.defra.gov.uk/productinformationdatabase/files/SPC_Documents/SPC_667196.PDF
• Alpha-Vet Allatgyogyaszati Kft Gefriderm cutaneous spray solution for dogs. Website: vmd.defra.gov.uk/productinformationdatabase/files/SPC_Documents/SPC_2078550.PDF

US

• There are no veterinary products containing ketoconazole licensed for use in dogs in the US.

Always follow the recommended dosage and contact your veterinary team or pharmacist if you have any questions regarding your dog’s medication.