Konazol

Ketoconazole

Method of action: Antifungal Broad Spectrum

Treatment option: Dermatitis, Jock Itch, Infection, Candidiasis,Vaginal, Cutaneous Candidiasis, Shingles, Seborrheic Dermatitis, Athlete'S Foot

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Konazol

Property	Description
Active ingredient	Ketoconazole
Form	Tablet (Oral), Cream, Shampoo, Gel, Foam (Topical)
Pharmacological class	Azole Antifungal / Imidazole Derivative
General purpose	Management of Fungal Infections (Mycoses)
Origin	Synthetic Compound

Konazol is a medicinal product whose active component is Ketoconazole, a synthetic antifungal agent primarily used to control the overgrowth of various fungi in the body. It is clinically recognized for its broad-spectrum activity against yeasts and dermatophytes. It is classified as an antimycotic and a single-ingredient product, offering both systemic medication and topical preparation options for patients with fungal infections.

1. Defining Konazol: An Azole Antifungal Agent

Konazol contains the active substance Ketoconazole, which belongs to the azole antifungal class of medicines, specifically identified as an Imidazole Derivative. This classification denotes a group of synthetic compounds that specifically target and disrupt fungal organisms rather than bacteria.

The classification places Ketoconazole as a first-generation azole, defining its particular chemical structure, which includes Imidazole and Dioxolane rings. The structure of this agent dictates its precise ability to address the underlying microbial cause of infections like mycoses, making it a focused therapeutic option. Ketoconazole inhibits the synthesis of ergosterol, a primary component of the fungal cell membrane.

2. Composition and Available Pharmaceutical Forms

The core composition of Konazol is centered entirely on Ketoconazole, a differentiating feature that makes it a single-ingredient product. It is available as two primary types of dosage form(s): a systemic medication and a topical preparation. The systemic medication is an oral formulation (Tablet), while the topical preparation is designed for localized application as a Cream, Shampoo, Gel, or Foam.

These distinct route(s) of administration allow for targeted therapeutic use; the oral formulation provides whole-body distribution, whereas the topical preparation is formulated with pharmaceutical bases to deliver the active ingredient directly to the affected area. Ketoconazole is classified as an antifungal for dermatological use.

3. General Purpose: Addressing Fungal Infections

The general purpose of Konazol is to manage and control fungal infections by limiting the growth and spread of the responsible organisms. This action stems from the ability of Ketoconazole to exert a powerful antifungal agent effect on susceptible fungi.

The way Ketoconazole achieves this is through ergosterol synthesis inhibition, the fundamental mechanism that stops the fungus from building its protective cell membrane. By compromising this vital structure, the medicine effectively carries out a fungistatic action (stopping growth) and, in some contexts, a fungicidal action (killing the organism). This core biological effect ensures that Konazol acts to remove the root cause of the mycoses and resolve the associated symptoms, such as addressing common skin conditions caused by yeast overgrowth.

Regulatory References

Ketoconazole - LiverTox - NIH

What side effects are possible with Konazol?

Konazol: Possible Side Effects and Safety Information

The safety profile of Konazol (Ketoconazole) is officially documented by regulatory authorities, classifying adverse reactions by frequency and physiological system. This information outlines the possible effects a patient may experience, strictly based on clinical trial and post-marketing data.

Systemic Safety Concerns

The most significant safety focus for the oral tablet formulation involves the risks of severe hepatotoxicity, which includes cases leading to liver failure. Additionally, the label notes the potential for adrenal insufficiency and blood disorders such as thrombocytopenia (decreased platelet count). These are considered serious adverse reactions as documented in regulatory sources.

Frequency Classification (Oral Formulation)	Example Adverse Reactions (Label-Documented)
Common (up to 1 in 10)	Nausea, vomiting, abdominal pain, diarrhea, headache, pruritus, rash.
Uncommon (up to 1 in 100)	Dizziness, somnolence, insomnia, alopecia, fever, chills.
Not Known (frequency unestimable)	Severe hepatotoxicity, adrenal insufficiency, gynecomastia, impotence.

Safety Considerations and Restrictions

The safety documentation specifies that the oral formulation is contraindicated in individuals with acute or chronic liver disease. The risk of liver injury may be greater with prolonged exposure. Furthermore, the label includes explicit restrictions against co-administering Konazol with specific medications due to the potential for serious interactions, such as those that can lead to dangerous cardiac rhythm changes (e.g., QT prolongation). Safety statements also note that the systemic risks primarily pertain to the oral tablet, while topical forms generally result in localized skin reactions.

Overdose and Emergency Response

Overdose and When to Seek Help

The official regulatory profile for Konazol overdose centers on potential severe systemic toxicity affecting the hepatic, cardiovascular, and adrenal systems. Overdose manifestations documented in official labeling include signs of acute liver injury, such as jaundice, fatigue, and nausea, alongside dangerous cardiac effects like QT prolongation, which can lead to life-threatening ventricular tachyarrhythmias, including Torsades de pointes. Additionally, overdose may result in adrenal insufficiency, presenting with generalized weakness or hypotension.

Due to the severity of these documented outcomes, regulatory authorities mandate immediate emergency action. Urgent medical attention must be sought for any suspected overdose. Emergency services must be contacted immediately if the affected individual exhibits severe signs such as trouble breathing, seizure, or loss of consciousness.

Management procedures are strictly symptomatic and supportive, as no specific antidote is listed in official regulatory documents. Required procedural steps involve rigorous continuous monitoring, including ECG observation for the QTc interval and frequent assessment of liver enzymes and electrolytes. For the oral formulation, gastric lavage with activated charcoal may be considered in early stages. Systemic overdose is not anticipated with topical use, but special considerations apply to accidental ingestion of the topical product, where induced vomiting should be avoided due to aspiration risk.

Therapeutic Uses of Konazol

What Konazol Treats: Main Uses and Benefits

Konazol is commonly used to help manage symptoms related to various conditions, targeting both localized microbial overgrowth and specialized systemic issues. It is relevant across domains where additional symptomatic support is needed.

The medication is applicable in addressing symptom clusters related to fungal infections like tinea, cutaneous candidiasis, and seborrheic dermatitis, and is also used for systemic mycoses such as histoplasmosis and coccidioidomycosis. Additionally, it plays a role in managing symptoms of Endogenous Cushing's Syndrome.

When addressing superficial infections, Konazol is applied in clinical settings that involve acute or unstable symptom patterns, particularly to ease itching (pruritus), scaling, and redness. This application provides supportive relief when symptoms interfere with routine activities, contributing to improved day-to-day comfort.

“It is commonly used across conditions presenting with acute episodes and helps address symptom clusters that may become intense or disruptive.”

In systemic contexts, the medication is relevant for easing the symptom burden associated with conditions marked by increased physiological stress, applied in settings marked by temporary physiological imbalance.

Quick Fact: Relief for Itching, Scaling, and Systemic Distress

Eligibility and Restrictions for Use

Konazol (ketoconazole) is primarily used in topical formulations (creams, shampoos) to treat various fungal and yeast skin infections. These include seborrheic dermatitis, tinea versicolor (sun fungus), tinea corporis (ringworm), tinea cruris (jock itch), and tinea pedis (athlete's foot).

Who Can Use Konazol (Topical)

Most healthy adults and adolescents (typically over 12 years of age) can safely use topical Konazol for localized fungal infections, provided there is no known allergy to ketoconazole or any other ingredient in the product.

Who Cannot Use Konazol (Topical and Oral)

Konazol's use is subject to specific contraindications, which are more critical for the oral tablet form due to risks of serious side effects like hepatotoxicity (liver damage).

Condition	Contraindication Level
Allergy to Ketoconazole	Absolute
Active or Chronic Liver Disease (especially Oral)	Absolute/Strong
Adrenal Insufficiency (especially Oral)	Strong Caution/Absolute
Use with certain interacting drugs (Oral)	Absolute
Children under 12	General Caution (Safety/Efficacy Not Established)
Pregnancy/Breastfeeding	Consult Physician (Potential Risks)

Oral Konazol is generally reserved for severe systemic fungal infections when other treatments are unavailable or have failed, and is not typically used for skin/nail infections due to the serious risks.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Konazol (Ketoconazole) is associated with numerous officially documented interactions, primarily based on its classification as a potent inhibitor of the CYP3A4 enzyme and the drug transporters P-glycoprotein (P-gp) and BCRP. This pharmacokinetic profile causes a clinically significant increase in the plasma concentrations of many co-administered medicines, increasing the risk of toxicity.

Formally Contraindicated Combinations

Co-administration is strictly contraindicated with specific agents due to the risk of severe reactions, including potentially fatal ventricular dysrhythmias (e.g., dofetilide, quinidine), enhanced sedation (e.g., oral midazolam), and muscle toxicity (e.g., simvastatin, lovastatin). The combination with certain ergot alkaloids is also prohibited.

Administration Requirements and Substance Interactions

Absorption Interference: Konazol's pH-dependent absorption profile requires mandatory timing separation. Acid-reducing medicines, such as antacids, must be administered at least 2 hours after Konazol intake to prevent a reduction in absorption.
Dietary and Substance Restrictions: Co-administration with alcohol is restricted due to the increased risk of serious liver damage and a potential disulfiram-like reaction. Grapefruit juice may increase Konazol exposure.
Disease-Related Restriction: Konazol is contraindicated in patients with pre-existing acute or chronic liver disease due to the compounded risk of hepatic toxicity.

These official restrictions outline the required constraints for co-administration, primarily to manage the risk arising from Konazol's inhibitory effects on drug metabolism and transport.

Mechanism of Action

Konazol (Ketoconazole) acts primarily through two distinct mechanistic domains: a targeted inhibition of fungal enzymes and a secondary modulation of human steroidogenic pathways.

Disrupting Fungal Cell Membrane Synthesis

Konazol's main mechanism is exerted on the fungal cell, where it functions as an inhibitor of the cytochrome P450 enzyme lanosterol 14-alpha-demethylase. This enzyme is critical for converting lanosterol into ergosterol, the fundamental sterol required for fungal cell membrane structure. The enzyme blockade interrupts the biosynthetic cascade, resulting in the depletion of ergosterol and the subsequent accumulation of toxic 14 -methylated sterol precursors. This dual molecular consequence directly alters the structural integrity and fluidity of the fungal cell membrane.

Modulating Human Steroid Production Pathways

At elevated systemic concentrations, Konazol is a non-selective inhibitor of several human cytochrome P450 enzymes ( CYP17 and CYP11B1) present in the adrenal glands and gonads. These enzymes mediate the final steps of steroid hormone synthesis. This pathway interference results in a reduction in circulating cortisol and testosterone levels, a system-level physiological consequence that modulates signaling patterns within the adrenal steroidogenic axis.

Dosage and Administration Information

How to Use Konazol: Administration Guidelines

This section describes the administration and dosing guidelines for Konazol (Ketoconazole).

Administration Scope

Feature	Guideline
Route of Administration	Systemic use is via the Oral route (tablet); Localized treatment uses the Topical/Dermal and Topical/Scalp routes (cream, shampoo, gel, foam).
Dosing Schedule	Adult Oral Dose: Typically 200 mg once daily, which may be increased to 400 mg once daily.
Frequency Pattern	Oral dosing is once daily. Topical formulations range from once daily to intermittent maintenance use, such as once every one or two weeks.
Timing in relation to meals	Oral tablets must be taken with a meal to enhance systemic absorption.

Administration Requirements and Duration

Systemic oral administration requires the tablet to be taken alongside food and mandates that the gastric acidity necessary for dissolution be maintained. Co-administration of the tablet with acid-reducing agents requires specific time separation to avoid impaired absorption.

Age-Group Administration: Oral dosing for pediatric patients aged two years and older is typically weight-based, while the safety and effectiveness for systemic use in patients under two years old are not established.

Topical Application: Topical usage, such as with the shampoo formulation, requires a specified contact time of approximately three to five minutes on the affected area before rinsing thoroughly. Treatment duration varies widely by the formulation and condition, ranging from fixed short courses for topical infections (e.g., two to six weeks) to long-term regimens of six months or more for systemic mycoses.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Konazol

Evidence for Topical Use in Seborrheic Dermatitis and Dandruff

Research has studied topical forms of Konazol, such as creams and shampoos, in short-term Randomized Controlled Trials (RCTs) where researchers examined the treatment of conditions like seborrheic dermatitis and dandruff. These trials primarily focused on adult and adolescent populations (aged 12 and older). The outcomes monitored in these studies included the assessment of clinical endpoints and the rate of mycological clearance, which is the elimination of the fungal organisms. Researchers also focused on specific patient-reported outcomes describing perceived discomfort, such as changes in itching and the visible signs of redness and scaling.

Studies report how symptom measurements changed in the observed populations over defined time intervals, typically around four weeks. Longer-term open-label reports monitored the frequency of symptomatic flares over periods up to one year. Data for children and very young age groups using some specific topical formulations remain insufficient, meaning that results apply only to the populations studied.

Evidence for Topical Use in Skin Fungus (Tinea)

The research examining Konazol for skin conditions caused by fungus, such as Tinea Pedis and Tinea Versicolor, includes controlled clinical studies and double-blind comparative trials. These studies have examined the product’s effect on various types of tinea, primarily in adult populations. The main outcomes research monitored were the rates of achieving clinical endpoints and mycological clearance following defined treatment periods.

While there is substantial research describing these short-term outcomes, follow-up durations were limited in many of the core trials. The focus is often placed on the immediate post-treatment findings, meaning that long-term effects are not fully established regarding how often symptoms or the infection return over extended periods.

Evidence for Oral Use in Endemic Systemic Fungal Infections

Research into the oral tablet formulation of Konazol focuses on its use for endemic systemic mycoses, which are conditions involving fungal growth throughout the body. The existing evidence is largely derived from older clinical trials and case series. These studies were generally conducted during periods of increased symptom activity where the patient had failed or could not tolerate alternative first-line therapies.

This evidence helps to contextualize symptom patterns in patients where the condition involves outcomes related to systemic or functional imbalance. The evidence base is historical, and many of these older studies had modest sample sizes and may not align with the context of current clinical standards.

Key Studies & References

An Efficacy Study of a New Formulation of Ketoconazole 2% Cream in Patients With Tinea Pedis (Athlete's Foot) - ClinicalTrials.gov (NCT01110330)

Frequently Asked Questions (FAQ)

Common questions about Konazol (FAQ)

Q: Is Konazol considered an over-the-counter medicine?

The availability of Konazol depends on the specific formulation. Official product information confirms that some topical preparations, such as the 1% ketoconazole shampoo, are sold over-the-counter (OTC). However, the oral tablets and 2% topical formulations are classified as prescription-only (Rx).

Q: Is Konazol available in generic form?

Yes, the active ingredient in Konazol, which is Ketoconazole, is widely available in multiple generic forms. These generic versions are available for both the oral tablets and various topical preparations, as listed in official drug directories.

Q: Are there different brand names for the medicine Konazol?

Yes, the active ingredient Ketoconazole is marketed under various brand names, depending on the country and the specific formulation (oral tablet, cream, or shampoo). Examples of other names include Nizoral and Extina.

Q: How quickly can I expect to notice anything after starting Konazol?

Official research for topical Konazol has examined changes in symptoms over defined treatment periods. Studies often report that symptom measurements change over time intervals, typically around four weeks, but the onset of relief can vary depending on the specific condition and formulation used.

Q: Can Konazol affect my ability to drive or operate machinery?

Regulatory documents mention that side effects of the oral tablet formulation can include dizziness and somnolence (drowsiness). These effects are noted in official sources as potentially impairing a patient's judgment, thinking, or motor skills.

Q: Can I take Konazol if I am already taking common pain relievers?

Konazol is classified in official sources as a potent inhibitor of the CYP3A4 enzyme, which is involved in metabolizing many other drugs. Because this action can increase the amount of a co-administered drug in the body, potentially raising the risk of toxicity, official information emphasizes discussing all current medications with a healthcare provider.

Q: Is Konazol safe for long-term use?

Official warnings regarding the oral tablet note that the risk of serious liver injury (hepatotoxicity) may be greater with prolonged exposure. For this reason, the oral formulation is generally reserved for severe systemic infections when other effective options are unavailable. Official documents describe the use of this drug in contexts where the benefits are determined to outweigh potential risks.

Q: Are there any serious withdrawal symptoms if I stop Konazol suddenly?

The oral tablet formulation is known to decrease the body's natural production of certain hormones. Abrupt discontinuation is a regulatory concern due to the potential for adrenal insufficiency. Official guidance emphasizes consultation with a healthcare provider before any changes to the treatment are made.

Q: What are the signs of an allergic reaction to Konazol?

According to official medication guides, signs of a serious allergic reaction may include rash, hives, and itching. Officially documented severe symptoms include swelling of the face, lips, or tongue, chest pain, and trouble breathing.

Q: Are there any natural supplements that should not be taken with Konazol?

Due to Konazol's inhibitory effect on the CYP3A4 enzyme, it can interact with a wide range of substances, including certain herbal and natural supplements. Official sources recommend discussing all supplements being used with a healthcare provider to manage the risk of drug exposure and toxicity.

Q: Does the time of day I take Konazol matter?

The oral tablet is typically prescribed to be taken once daily and must be taken with a meal to aid absorption. However, official regulatory documents do not specify a mandatory time of day, such as requiring it in the morning or evening.

Q: Can Konazol be taken by individuals with kidney problems?

Official information on the oral tablet indicates that the drug's pharmacokinetics are not significantly different in patients with renal failure compared to healthy subjects. As a result, no specific dose adjustment is typically recommended for patients who have kidney problems.

Q: Is it necessary to finish the entire course of Konazol, even if I feel better?

Official medication guides state that discontinuation of Konazol tablets should first be discussed with a healthcare provider. This statement is included in the guidance to help ensure the infection is fully addressed and to manage potential systemic risks upon cessation.

Q: Can taking Konazol make me more sensitive to the sun?

Adverse event reports filed in regulatory documents indicate that increased sensitivity to sunlight (photosensitivity) has been reported in patients using Konazol. Official documents suggest that precautions regarding sun exposure are a topic for patient discussion with a healthcare provider.

Q: What should I do if a side effect seems mild but bothersome?

Regulatory patient counseling indicates that individuals should discuss any unusual problems or bothersome effects that occur while taking the medication with their healthcare provider. This ensures that side effects are addressed appropriately.

Q: Why is Konazol sometimes not suitable for older adults?

Regulatory documents state that data on the use of the drug in patients older than 65 years is limited. However, there is no official evidence to suggest that a specific dose adjustment is generally required based on advanced age alone. Restrictions are typically based on underlying conditions, such as liver or cardiac risks.

Q: Do official documents mention Konazol causing fatigue?

Official medication guides list 'unusual tiredness or weakness' and 'fatigue' as symptoms that have been reported. These effects may be associated with the drug itself or could be a sign of potential serious adverse reactions, such as adrenal insufficiency or liver problems.

Q: Can I use Konazol if I have diabetes?

Diabetes itself is not listed as an absolute contraindication for Konazol in regulatory labels. However, conditions like diabetes may increase a patient's baseline cardiovascular or liver risk, and official information emphasizes careful assessment if Konazol treatment is initiated.

Q: Is Konazol safe for people with high blood pressure?

High blood pressure (hypertension) is not listed as an absolute contraindication for Konazol. Official sources note that Konazol can interact with certain blood pressure medications, and official information emphasizes careful risk assessment when the drug is considered.

How should Konazol be stored and disposed of?

How to Store and Dispose of Konazol (Ketoconazole)

Storage and handling requirements for Konazol vary by formulation and must adhere strictly to official regulatory labeling to ensure product stability and patient safety.

Storage Requirements

Formulation	Temperature & Protection	Container & Safety
Oral Tablets	Store at 20 C to 25 C (68 F to 77 F); protect from moisture.	Keep in the original container and out of the sight and reach of children.
Topical Shampoo	Store not above 25 C (77 F); protect from light.	Keep out of the sight and reach of children.
Topical Gel	Store at 25 C (77 F). Flammable; avoid fire, flame, or smoking nearby.	Keep out of the sight and reach of children.