ketoconazole ๐Ÿถ Veterinary Use | Indications/Contra | FAERs-F | FAERs-M | Orange Bk | BioActivity |

Stem definitionDrug idCAS RN
systemic antifungal agents, miconazole derivatives 1527 65277-42-1

Description:

MoleculeDescription

Molfile Inchi Smiles

Synonyms:

  • ketoconazole
  • (+/-)-ketoconazole
  • brizoral
  • fungarest
  • fungoral
  • ketoderm
  • ketoisdin
  • ketozoral
  • nizoral
  • nizral
  • panfungol
  • ketoconazol
  • R-41400
Broad spectrum antifungal agent used for long periods at high doses, especially in immunosuppressed patients.
  • Molecular weight: 531.43
  • Formula: C26H28Cl2N4O4
  • CLOGP: 3.44
  • LIPINSKI: 1
  • HAC: 8
  • HDO: 0
  • TPSA: 69.06
  • ALOGS: -4.76
  • ROTB: 7

  • Status: OFP

  • Legend:
    OFP - off patent
    OFM - off market
    ONP - on patent

Drug dosage:

DoseUnitRoute
0.40 g V
0.60 g O
0.20 g O

ADMET properties:

PropertyValueReference
BDDCS (Biopharmaceutical Drug Disposition Classification System) 2 Benet LZ, Broccatelli F, Oprea TI
S (Water solubility) 0.01 mg/mL Benet LZ, Broccatelli F, Oprea TI
EoM (Fraction excreted unchanged in urine) 3 % Benet LZ, Broccatelli F, Oprea TI
MRTD (Maximum Recommended Therapeutic Daily Dose) 10.75 ยตM/kg/day Contrera JF, Matthews EJ, Kruhlak NL, Benz RD
BA (Bioavailability) 75 % Kim MT, Sedykh A, Chakravarti SK, Saiakhov RD, Zhu H

Approvals:

DateAgencyCompanyOrphan
June 12, 1981 FDA JANSSEN PHARMS

FDA Adverse Event Reporting System (Female)

MedDRA adverse event termLikelihood ratioLikelihood ratio thresholdPatients taking drug having adverse eventPatients taking drug not having adverse eventPatients not taking drug having adverse eventPatients not taking drug not having adverse event
Psoriasis 114.25 13.86 98 9336 68902 50526788
Cortisol increased 40.11 13.86 10 9424 350 50595340
Hypothalamic pituitary adrenal axis suppression 37.12 13.86 8 9426 145 50595545
Purpura senile 36.30 13.86 10 9424 519 50595171
Tarsal tunnel syndrome 36.11 13.86 10 9424 529 50595161
Product dose omission issue 33.30 13.86 92 9342 183746 50411944
Exposure during pregnancy 31.94 13.86 70 9364 120945 50474745
Adrenal insufficiency 31.52 13.86 24 9410 14219 50581471
Abortion spontaneous 28.49 13.86 37 9397 41735 50553955
Pneumonia mycoplasmal 27.53 13.86 9 9425 840 50594850
Vertigo positional 27.40 13.86 12 9422 2499 50593191
Resorption bone increased 25.99 13.86 9 9425 1002 50594688
Drug interaction 24.23 13.86 87 9347 199534 50396156
Vestibular disorder 23.99 13.86 9 9425 1260 50594430
Aspergillus test positive 21.53 13.86 6 9428 325 50595365
Deafness bilateral 20.68 13.86 8 9426 1218 50594472
Swelling of eyelid 20.66 13.86 9 9425 1851 50593839
Dermatitis atopic 20.48 13.86 11 9423 3575 50592115
Drug clearance increased 17.83 13.86 4 9430 88 50595602
Blood uric acid decreased 17.25 13.86 6 9428 676 50595014
Psoriatic arthropathy 16.94 13.86 31 9403 47001 50548689
Seborrhoeic dermatitis 16.27 13.86 6 9428 801 50594889
Hypertrophy 16.27 13.86 5 9429 382 50595308
Otitis media 15.94 13.86 10 9424 4339 50591351
Haematopoietic neoplasm 14.78 13.86 3 9431 40 50595650
Systemic lupus erythematosus 14.72 13.86 4 9430 140618 50455072
Impetigo 14.12 13.86 6 9428 1161 50594529
Bronchopulmonary aspergillosis allergic 14.00 13.86 6 9428 1185 50594505

FDA Adverse Event Reporting System (Male)

MedDRA adverse event termLikelihood ratioLikelihood ratio thresholdPatients taking drug having adverse eventPatients taking drug not having adverse eventPatients not taking drug having adverse eventPatients not taking drug not having adverse event
Psoriasis 33.79 13.33 46 9255 32181 29533045
Prostatic specific antigen increased 32.79 13.33 29 9272 12535 29552691
Therapeutic response unexpected 26.75 13.33 22 9279 8616 29556610
Transient aphasia 25.54 13.33 6 9295 94 29565132
Colour vision tests normal 25.49 13.33 4 9297 4 29565222
Anaplastic astrocytoma 24.50 13.33 6 9295 113 29565113
Seborrhoeic dermatitis 24.46 13.33 11 9290 1442 29563784
Central vision loss 22.03 13.33 4 9297 15 29565211
Eczema 21.37 13.33 24 9277 13802 29551424
Alcohol intolerance 21.35 13.33 7 9294 388 29564838
Toxicity to various agents 20.32 13.33 15 9286 173646 29391580
Off label use 19.99 13.33 162 9139 300638 29264588
Rhabdomyolysis 19.20 13.33 52 9249 60756 29504470
Bone disorder 18.48 13.33 15 9286 5768 29559458
Guttate psoriasis 17.98 13.33 5 9296 157 29565069
Vitamin E deficiency 17.04 13.33 3 9298 9 29565217
Metastases to bone 16.71 13.33 18 9283 9880 29555346
Polyarteritis nodosa 16.66 13.33 5 9296 207 29565019
Product dose omission issue 16.53 13.33 67 9234 96316 29468910
Blood testosterone decreased 16.52 13.33 12 9289 3918 29561308
Herpes virus infection 16.11 13.33 10 9291 2521 29562705
Hepatitis fulminant 15.23 13.33 11 9290 3560 29561666
Headache 15.12 13.33 100 9201 173907 29391319
Dermatitis 14.63 13.33 15 9286 7783 29557443
Product use issue 14.28 13.33 42 9259 51402 29513824
Adrenal insufficiency 13.40 13.33 17 9284 11097 29554129
Melanocytic naevus 13.33 13.33 8 9293 1898 29563328

FDA Adverse Event Reporting System (Geriatric)

MedDRA adverse event termLikelihood ratioLikelihood ratio thresholdPatients taking drug having adverse eventPatients taking drug not having adverse eventPatients not taking drug having adverse eventPatients not taking drug not having adverse event
Psoriasis 98.74 12.07 99 14110 71604 64412919
Cortisol increased 45.90 12.07 12 14197 429 64484094
Product dose omission issue 45.51 12.07 119 14090 194628 64289895
Seborrhoeic dermatitis 36.11 12.07 14 14195 1812 64482711
Adrenal insufficiency 34.56 12.07 33 14176 22454 64462069
Toxicity to various agents 33.88 12.07 19 14190 363494 64121029
Tarsal tunnel syndrome 30.65 12.07 9 14200 496 64484027
Hypothalamic pituitary adrenal axis suppression 30.60 12.07 8 14201 286 64484237
Purpura senile 30.55 12.07 9 14200 502 64484021
Drug interaction 29.98 12.07 158 14051 361925 64122598
Rhabdomyolysis 28.91 12.07 63 14146 91663 64392860
Eczema 28.58 12.07 34 14175 29686 64454837
Colour vision tests normal 26.91 12.07 4 14205 4 64484519
Impetigo 25.92 12.07 11 14198 1795 64482728
Anaplastic astrocytoma 25.21 12.07 6 14203 145 64484378
Transient aphasia 24.39 12.07 6 14203 167 64484356
Vertigo positional 23.80 12.07 12 14197 2899 64481624
Resorption bone increased 23.25 12.07 9 14200 1159 64483364
Central vision loss 22.69 12.07 4 14205 19 64484504
Therapeutic response unexpected 22.50 12.07 23 14186 16978 64467545
Pneumonia mycoplasmal 22.08 12.07 9 14200 1327 64483196
Swelling of eyelid 20.79 12.07 10 14199 2182 64482341
Vestibular disorder 20.36 12.07 10 14199 2283 64482240
Drug abuse 19.36 12.07 3 14206 132371 64352152
Cortisol free urine decreased 17.44 12.07 3 14206 12 64484511
Vitamin E deficiency 16.43 12.07 3 14206 18 64484505
Dermatitis 16.31 12.07 20 14189 18009 64466514
Infusion related reaction 16.18 12.07 8 14201 164459 64320064
Deafness bilateral 16.12 12.07 8 14201 1868 64482655
Hepatitis fulminant 15.32 12.07 12 14197 6262 64478261
Alcohol intolerance 15.31 12.07 5 14204 393 64484130
Guttate psoriasis 15.27 12.07 5 14204 396 64484127
Polyarteritis nodosa 14.46 12.07 5 14204 468 64484055
Penile oedema 14.41 12.07 4 14205 180 64484343
Hepatotoxicity 14.39 12.07 29 14180 39933 64444590
Blood uric acid decreased 13.47 12.07 6 14203 1100 64483423
Drug clearance increased 13.42 12.07 4 14205 232 64484291
Headache 13.17 12.07 176 14033 529291 63955232
Pathogen resistance 13.14 12.07 15 14194 12528 64471995
Dermatitis atopic 13.05 12.07 9 14200 3867 64480656
Application site swelling 12.97 12.07 5 14204 637 64483886
Psoriatic arthropathy 12.81 12.07 29 14180 43252 64441271
Swelling face 12.62 12.07 35 14174 59131 64425392
Myotonic dystrophy 12.51 12.07 3 14206 75 64484448
Aspergillus test positive 12.49 12.07 5 14204 703 64483820
Muscle fatigue 12.45 12.07 8 14201 3057 64481466
Dermatitis psoriasiform 12.34 12.07 7 14202 2139 64482384
Hyperadrenocorticism 12.27 12.07 4 14205 312 64484211
Hypertrophy 12.15 12.07 5 14204 755 64483768

FDA Adverse Event Reporting System (Pediatric)

None

Pharmacologic Action:

SourceCodeDescription
ATC D01AC08 DERMATOLOGICALS
ANTIFUNGALS FOR DERMATOLOGICAL USE
ANTIFUNGALS FOR TOPICAL USE
Imidazole and triazole derivatives
ATC G01AF11 GENITO URINARY SYSTEM AND SEX HORMONES
GYNECOLOGICAL ANTIINFECTIVES AND ANTISEPTICS
ANTIINFECTIVES AND ANTISEPTICS, EXCL. COMBINATIONS WITH CORTICOSTEROIDS
Imidazole derivatives
ATC H02CA03 SYSTEMIC HORMONAL PREPARATIONS, EXCL. SEX HORMONES AND INSULINS
CORTICOSTEROIDS FOR SYSTEMIC USE
ANTIADRENAL PREPARATIONS
Anticorticosteroids
ATC J02AB02 ANTIINFECTIVES FOR SYSTEMIC USE
ANTIMYCOTICS FOR SYSTEMIC USE
ANTIMYCOTICS FOR SYSTEMIC USE
Imidazole derivatives
FDA CS M0002083 Azoles
FDA EPC N0000175487 Azole Antifungal
MeSH PA D058888 14-alpha Demethylase Inhibitors
MeSH PA D000890 Anti-Infective Agents
MeSH PA D000935 Antifungal Agents
MeSH PA D065692 Cytochrome P-450 CYP3A Inhibitors
MeSH PA D065607 Cytochrome P-450 Enzyme Inhibitors
MeSH PA D004791 Enzyme Inhibitors
MeSH PA D006727 Hormone Antagonists
MeSH PA D065606 Metabolic Side Effects of Drugs and Substances
MeSH PA D065088 Steroid Synthesis Inhibitors
FDA MoA N0000182141 Cytochrome P450 3A4 Inhibitors
FDA MoA N0000185503 P-Glycoprotein Inhibitors
FDA MoA N0000190115 Cytochrome P450 3A5 Inhibitors

Drug Use | Suggest Off label Use Form| |View source of the data|

DiseaseRelationSNOMED_IDDOID
Tinea pedis indication 6020002 DOID:12403
Histoplasmosis indication 12962009 DOID:1731
Hypercortisolism indication 47270006
Candidiasis of skin indication 49883006
Seborrheic dermatitis indication 50563003 DOID:8741
Pityriasis versicolor indication 56454009 DOID:9060
Paracoccidioidomycosis indication 59925007 DOID:12662
Coccidioidomycosis indication 60826002 DOID:13450
Blastomycosis indication 69996000 DOID:12663
Disseminated candidiasis indication 70572005
Candidiasis of mouth indication 79740000 DOID:14262
Tinea corporis indication 84849002
Chromoblastomycosis indication 187079000
Pityriasis simplex indication 200767005
Tinea cruris indication 399029005
Paronychia off-label use 71906005 DOID:13117
Advanced Prostatic Carcinoma off-label use
Torsades de pointes contraindication 31722008
Achlorhydria contraindication 47481007
Prolonged QT interval contraindication 111975006
Disease of liver contraindication 235856003 DOID:409
Telangiectasia disorder contraindication 247479008
Adrenal cortical hypofunction contraindication 386584007 DOID:10493
Atrophoderma contraindication 399979006
Peripheral vascular disease contraindication 400047006
Congenital long QT syndrome contraindication 442917000




๐Ÿถ Veterinary Drug Use

None

๐Ÿถ Veterinary products

None

Acid dissociation constants calculated using MoKa v3.0.0

Dissociation levelDissociation constantType (acidic/basic)
pKa1 5.84 Basic
pKa2 3.5 Basic

Orange Book patent data (new drug applications)

None

Orange Book exclusivity data (new drug applications)

None

Bioactivity Summary:

TargetClassPharosUniProtActionTypeActivity value
(-log[M])
Mechanism
action
Bioact sourceMoA source
Steroid 17-alpha-hydroxylase/17,20 lyase Enzyme INHIBITOR IC50 7.28 WOMBAT-PK DRUG LABEL
Cytochrome P450 11B1, mitochondrial Enzyme INHIBITOR IC50 6.90 SCIENTIFIC LITERATURE DRUG LABEL
Cytochrome P450 3A4 Enzyme Ki 7 WOMBAT-PK
Multidrug resistance protein 1 Transporter Ki 6 WOMBAT-PK
Sodium-dependent serotonin transporter Transporter Ki 6.55 DRUG MATRIX
Sodium-dependent noradrenaline transporter Transporter Ki 4.62 DRUG MATRIX
Alpha-2B adrenergic receptor GPCR Ki 5.08 DRUG MATRIX
Histamine H2 receptor GPCR Ki 4.67 DRUG MATRIX
Muscarinic acetylcholine receptor M2 GPCR Ki 5.03 DRUG MATRIX
Aldehyde oxidase Enzyme IC50 5.46 WOMBAT-PK
Sodium-dependent dopamine transporter Transporter Ki 4.73 DRUG MATRIX
Nuclear receptor subfamily 1 group I member 2 Nuclear hormone receptor WOMBAT-PK
Alpha-1D adrenergic receptor GPCR Ki 4.84 DRUG MATRIX
Delta-type opioid receptor GPCR Ki 5.35 DRUG MATRIX
Bile salt export pump Transporter IC50 5.54 CHEMBL
Cytochrome P450 2C9 Enzyme IC50 4.40 CHEMBL
Aromatase Enzyme Ki 6.40 CHEMBL
25-hydroxyvitamin D-1 alpha hydroxylase, mitochondrial Enzyme IC50 6.47 CHEMBL
Potassium voltage-gated channel subfamily A member 10 Ion channel BLOCKER IC50 6.30 IUPHAR
Cytochrome P450 2C19 Enzyme IC50 4.72 CHEMBL
Thromboxane-A synthase Enzyme IC50 5.67 DRUG MATRIX
Lanosterol 14-alpha demethylase Enzyme app Ki 7.20 WOMBAT-PK
Indoleamine 2,3-dioxygenase 1 Enzyme IC50 4.60 CHEMBL
Solute carrier family 22 member 1 Transporter IC50 5.58 CHEMBL
Substance-K receptor GPCR Ki 5.24 DRUG MATRIX
Cytochrome P450 3A5 Enzyme IC50 6.92 CHEMBL
1,25-dihydroxyvitamin D(3) 24-hydroxylase, mitochondrial Enzyme IC50 6.51 WOMBAT-PK
Cytochrome P450 21 Enzyme IC50 5.05 CHEMBL
Sodium/nucleoside cotransporter 1 Transporter Ki 5.82 DRUG MATRIX
Cytochrome P450 11B2, mitochondrial Enzyme INHIBITOR IC50 7.17 SCIENTIFIC LITERATURE
Alpha-2A adrenergic receptor GPCR Ki 5.13 DRUG MATRIX
Potassium voltage-gated channel subfamily H member 2 Ion channel IC50 5.72 WOMBAT-PK
Lanosterol 14-alpha demethylase Enzyme INHIBITOR IC50 7 WOMBAT-PK CHEMBL
Arachidonate 15-lipoxygenase Enzyme IC50 5.27 DRUG MATRIX
Alpha-1B adrenergic receptor GPCR Ki 4.90 DRUG MATRIX
5-hydroxytryptamine receptor 1B GPCR Ki 5.21 DRUG MATRIX
Membrane-associated progesterone receptor component 1 Membrane receptor Ki 5.01 DRUG MATRIX
Alpha-1A adrenergic receptor GPCR IC50 4.45 CHEMBL
Gonadotropin-releasing hormone receptor GPCR Kd 9.66 CHEMBL
Cytochrome P450 11B1 Enzyme IC50 6.82 CHEMBL
Cytochrome P450 11A1 Enzyme IC50 5.91 CHEMBL
Cytochrome P450 24A1 Enzyme IC50 4.70 CHEMBL
Cytochrome P450 7A1 Enzyme IC50 6.71 CHEMBL
Cytochrome P450 51 Enzyme Ki 7.19 CHEMBL
Bile salt export pump Transporter IC50 4.81 CHEMBL
25-hydroxyvitamin D-1 alpha hydroxylase, mitochondrial Enzyme IC50 6.44 CHEMBL
Cytochrome P450 17A1 Enzyme IC50 6.69 CHEMBL

External reference:

IDSource
4019271 VUID
N0000147470 NUI
D00351 KEGG_DRUG
4019271 VANDF
C0022625 UMLSCUI
CHEBI:47519 CHEBI
KTN PDB_CHEM_ID
CHEMBL157101 ChEMBL_ID
CHEMBL295698 ChEMBL_ID
D007654 MESH_DESCRIPTOR_UI
DB01026 DRUGBANK_ID
2568 IUPHAR_LIGAND_ID
4594 INN_ID
R9400W927I UNII
456201 PUBCHEM_CID
202692 RXNORM
2701 MMSL
31001 MMSL
4945 MMSL
d00103 MMSL
002903 NDDF
387216007 SNOMEDCT_US
40232005 SNOMEDCT_US

Pharmaceutical products:

ProductCategoryIngredientsNDCFormQuantityRouteMarketingLabel
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 0093-3219 CREAM 20 mg TOPICAL ANDA 17 sections
ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 0168-0099 CREAM 20 mg TOPICAL ANDA 16 sections
Ketaconazole HUMAN PRESCRIPTION DRUG LABEL 1 0378-7007 AEROSOL, FOAM 20 mg TOPICAL NDA authorized generic 26 sections
EXTINA HUMAN PRESCRIPTION DRUG LABEL 1 0378-8136 AEROSOL, FOAM 20 mg TOPICAL NDA 25 sections
Xolegel HUMAN PRESCRIPTION DRUG LABEL 1 16110-080 GEL 20 mg TOPICAL NDA 27 sections
KETOCONAZOLE HUMAN PRESCRIPTION DRUG LABEL 1 16590-998 TABLET 200 mg ORAL ANDA 22 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 16714-955 CREAM 20 mg TOPICAL ANDA 18 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 21695-554 CREAM 20 mg TOPICAL ANDA 19 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 21695-555 CREAM 20 mg TOPICAL ANDA 19 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 21695-556 CREAM 20 mg TOPICAL ANDA 19 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 21695-562 TABLET 200 mg ORAL ANDA 23 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 21922-025 CREAM 20 mg TOPICAL ANDA 15 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 33261-739 TABLET 200 mg ORAL ANDA 26 sections
KETOCONAZOLE HUMAN PRESCRIPTION DRUG LABEL 1 35573-433 TABLET 200 mg ORAL ANDA 15 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 43063-882 TABLET 200 mg ORAL ANDA 26 sections
Ketodan HUMAN PRESCRIPTION DRUG LABEL 1 43538-530 AEROSOL, FOAM 20 mg TOPICAL ANDA 28 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 45802-465 SHAMPOO, SUSPENSION 20 mg TOPICAL ANDA 18 sections
ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 45802-532 AEROSOL, FOAM 2 g TOPICAL ANDA 27 sections
ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 50090-0720 CREAM 20 mg TOPICAL ANDA 16 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 50090-1220 SHAMPOO, SUSPENSION 20 mg TOPICAL ANDA 18 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 50090-1524 CREAM 20 mg TOPICAL ANDA 18 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 50090-1675 CREAM 20 mg TOPICAL ANDA 18 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 50090-1992 TABLET 200 mg ORAL ANDA 26 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 50090-3288 SHAMPOO, SUSPENSION 20.50 mg TOPICAL ANDA 17 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 50090-5265 CREAM 20 mg TOPICAL ANDA 17 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 50090-5265 CREAM 20 mg TOPICAL ANDA 17 sections
Nizoral HUMAN PRESCRIPTION DRUG LABEL 1 50458-680 SHAMPOO 20 mg TOPICAL NDA 20 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 51407-279 CREAM 20 mg TOPICAL ANDA 19 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 51672-1298 CREAM 20 mg TOPICAL ANDA 19 sections
Ketoconazole HUMAN PRESCRIPTION DRUG LABEL 1 51672-4026 TABLET 200 mg ORAL ANDA 26 sections