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What Factors Affect a Sufficient Ketoconazole Dose?

By S. Berger
Updated: May 17, 2024

Ketoconazole is an antifungal medication used to treat many kinds of infections. The condition that it is used to treat generally determines the dose that is used. An appropriate ketoconazole dose may be influenced by other factors as well, including the age and weight of the patient, as well as any other medical conditions that an individual may have.

Oral thrush is a common infection of the mouth, and it is usually treated with an oral ketoconazole dose of 200 milligrams (mg) each day. Severe infections, or infections that do not respond adequately to the initial dose may be treated with a slightly larger dose of 400 mg per day, for a total of one to two weeks. This dosage regimen, like most regimens with this medication, is continued even if symptoms disappear before then.

Dermatophytosis, a skin condition, is treated with a daily dose of 200 mg of this medication, taken orally. Particularly widespread or resistant infections may require a larger ketoconazole dose of 400 mg per day. Treatment time for this condition is somewhat longer than that for oral thrush, and continues for a total of four weeks.

Blastomycosis, coccidioidomycosis, and histoplasmosis are all rarer fungal infections that are treated with an oral ketoconazole dose of 200 mg daily. A 400 mg daily dose may be used for more extreme cases. The length of time for treating these infections require a daily use of this medication for six months.

Children with fungal infections can also be treated with this medication, but a smaller dose is used. For children over two years of age, a ketoconazole dose based on weight is used. The oral dose may vary from 3.3 mg to 6.6 mg per 1 kilogram (kg) of body weight, or 3.3 mg to 6.6 mg per 2.2 pounds (lb) of body weight. Lengths of treatment times for children are generally the same as adults.

Individuals with liver damage may have to use somewhat smaller doses of this medication, since liver damage may slow the breakdown of this medication, allowing it to stay in the system longer. Additionally, some people may experience liver damage as a result of the use of ketoconazole. A doctor may require that these individuals have frequent monitoring of their liver enzyme levels during treatment. Alternately, a topical solution of 2% ketaconazole cream may be used for topical infections that do not necessarily require use of oral medication.

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