Mechanism of action of the drug
Based on a decrease in the synthesis of protein in the cell wall of fungi. Due to this, there is a decrease in activity and growth. When using this drug, conditions are created for the death of fungi. Due to the reduction in the production of ergosterol, the main component of the cell, a fungicidal effect occurs. The drug also has a fungiostatic effect. That is, a new number of mushrooms are not formed. Two such effects allow you to completely get rid of fungal flora.
In addition, the second component in the mechanism of action is the interaction of the active substance with cell enzymes. Due to this, a large amount of free oxygen is formed and the complete death of the mushrooms occurs.
The active substance also has a slight antimicrobial effect. It manifests itself in the form of a bacteriostatic effect. Applies to staphylococci and streptococci. Thanks to this, the formation of secondary complications in fungal diseases of the skin and mucous membranes does not occur.
The composition also includes additional components. They are secondary and do not have any effect on fungal cells.
Drug interactions
The CYP3A4 isoenzyme is involved in the metabolism of ketoconazole. The pharmacokinetics of ketoconazole may be affected by other substances with the same metabolic pathway or those affecting the activity of cytochrome P450. Ketoconazole may also affect the pharmacokinetics of other substances with the same metabolic pathway. Ketoconazole is a potent inhibitor of cytochrome P450 CYP3A4 and P-glycoprotein. When carrying out concomitant therapy, it is necessary to read the relevant instructions for use to obtain information about the route of their metabolism and the possible need for dose adjustment.
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Indications for use
Nizoral cream is used for diseases of the skin only. That is, it is used as a substance for external use. Indications for use are the following diseases:
- candidiasis of the skin;
- trichophytosis and microxporia;
- dermatophytosis;
- dermatomycosis of the feet and soles;
- onychomycosis;
- lichen simplex, pityriasis versicolor, multi-colored;
- seborrhea of the head;
- candidiasis of the external genitalia.
Nizoral ointment is used in both adults and children. When used, a small part is absorbed into the blood. Complete elimination from the body occurs within a day. This is achieved using the renal system. Since the concentration is insignificant, no pronounced side effects develop on the part of various organs and systems.
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pharmachologic effect
Ketoconazole has antifungal properties, providing a fungicidal and fungistatic effect . The drug copes well with the following types of fungi:
- dimorphic and yeast type;
- dermatophytes;
- pityrosporum orbiculare;
- pityrosporum ovale (causative agent of seborrheic dermatitis).
The drug prevents fungi from multiplying normally, violating the integrity of their cell membrane. The product interferes with the formation of lipids and ergosterol in fungal cells.
Nizoral effectively affects the skin, but does not enter the blood of an adult. Helps alleviate the symptoms of dermatological diseases: reduce itching and burning, remove peeling on the face that occurs due to seborrhea.
Methods of application
To obtain the desired effect, the cream should be applied in a thin layer several times a day. The duration of treatment ranges from 1 to several weeks. For skin candidiasis, apply the cream twice a day. In this case, the skin area must be thoroughly cleaned before application. This promotes better penetration of the active substance into the surface layer of the skin and the development of a fungicidal effect. Then the ointment must be applied in a small amount to the affected area.
When treating trichophytosis and microsporia, the use of ointment is required at least 3 times a day. To do this, apply a thin layer of cream to the area with fungal infection. If necessary, you should shave an area of the scalp if the fungal infection is located there.
Dermatophytosis is recommended to be treated for 3 weeks. In this case, the cream should be applied even after the symptoms subside. This is important, since mushrooms are among those capable of sporulation. Therefore, longer use of medications is required for complete cure.
Onychomycosis is treated within 2 weeks. As a rule, several more courses of treatment are required. Since this disease requires careful and long-term use of drugs. When treating seborrhea of the head, the cream must be applied at night for 3 weeks. Then take a break for three months. And then you should repeat the treatment again.
Indications
The drug is prescribed to patients suffering from the following diseases:
- seborrhea affecting the scalp and face;
- candidiasis;
- epidermophotia in the groin, feet and hands;
- mycosis and dermatomycosis;
- pityriasis versicolor.
One of the keys to treating seborrheic dermatitis is combating the disease-causing yeast called Pityrosporum. Prescribing Nizoral or similar antifungal agents for external use is necessary for effective treatment of both dry and oily seborrhea.
Side effects
Undesirable effects are associated with the development of a local allergic reaction. It is important that it can occur both for the first and subsequent use. This is due to increased sensitivity to the components of the drug.
Long-term use leads to activation of the enzyme, which contributes to increased development of allergies. Therefore, if itching, redness and swelling develop, you should stop using the drug.
Sometimes negative effects from the gastrointestinal tract may occur in the form of nausea and vomiting. Rarely, headache and weakness may occur.
The skin may develop peeling, redness, erythema and itching.
Contraindications
Not recommended for women in the first trimester of pregnancy. During lactation, this compound should be used with caution. Not recommended for use in children under 3 years of age.
Do not apply the ointment to wound surfaces or to areas with severe damage to the integrity of the skin.
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Use of tablets
The mechanism of action is fungicidal and fungiostatic. The effect is achieved within a few hours after taking the tablets.
The prescription of tablets for fungal diseases occurs in the case of systemic development of mycosis. In addition, they are used for severe and recurrent candidiasis of the mucous membranes. These include:
- vaginal candidiasis;
- recurrence of fungal infection of the esophageal mucosa;
- long-term persistent oral mycosis.
Another indication for oral administration is the lack of effect from previous therapy. Also, if the patient has increased sensitivity to the use of external forms. For prevention, tablets can be used in people with low immunity.
Side effects in this case occur against the background of increased concentration in the systemic circulation. Dyspeptic disorders may occur from the gastrointestinal tract. Headaches and increased fatigue are noted. Sometimes liver dysfunction is observed. There were no side effects from the immune system. Sometimes photophobia may occur. Uncommon: minor nosebleeds.
All side effects are included in the instructions after a certain period of use. Even the presence of one case is subject to registration.
Description of the drug
Today, Nizoral can be purchased in the form of shampoo, cream, tablets and vaginal suppositories.
Ketoconazole in its composition has fungicidal and fungistatic properties that destroy dimorphic and yeast fungi, pityriasis versicolor, dermatophytes, trichophytons, eumycetes, streptococci, staphylococci and other pathogens. The drug has proven itself in the treatment of seborrhea, systemic mycoses, chronic vaginal candidiasis, fungal infections of the mucous membranes of the gastrointestinal tract. In addition, Nizoral is prescribed to people with reduced immunity (in particular, after chemotherapy) and fungal diseases of the skin, nails and soft tissues. The main active ingredient of Nizoral, ketoconazole, is not absorbed into the systemic circulation when the drug is used externally.
How to Simply Recommend
Why the medicine does not work The key to successful treatment is, of course, following all the doctor’s recommendations and informing him of all significant changes during therapy. However, a specialist can talk as much as he wants about the regimen and duration of taking the drug, but most patients will still violate these rules. Read more
Contraindications to taking this drug in tablets are severe pathologies of the liver and kidneys, pregnancy and breastfeeding. Nizoral shampoo and cream can be used by pregnant and breastfeeding women - but only after consultation with your doctor. Also, the drug should not be taken if you are hypersensitive to ketoconazole. You should take Nizoral tablets with caution if you have hormonal imbalances, are undergoing hepatotoxic therapy, and are over 50 years of age. Also, you cannot combine Nizoral tablets with low-hormonal contraceptives, as this can cause bleeding.
Methods of using tablets
The prescription of tablets and determination of the duration of treatment is carried out by a doctor. Adults are recommended to take 2 tablets per day to achieve the effect. For children weighing up to 30 kg, no more than 1 tablet per day. For vaginal candiosis, it is recommended to take 2 tablets throughout the week.
For the treatment of skin mycoses, it is necessary to use tablets for about 4 weeks. The longest treatment is six months. It is prescribed only in the case of systemic mycoses. These include damage to organs and systems by fungal infection. Any form of lichen is treated within 2 weeks.
The maximum single dose is no more than 400 mg per day. Children over 3 years of age are recommended to take half a tablet per day. If symptoms of liver damage develop in the form of yellowness of the skin and pain on the right side, you should stop taking the medication.
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Instructions for use of Nizoral
It is recommended to take Nizoral tablets with meals . Adults should take 200 mg/day. In some cases, the dosage is increased to 400 mg.
The duration of treatment varies depending on the diagnosis. Treatment of dermatomycosis lasts at least one month, onychomycosis - six months or a year, pityriasis versicolor - 10 days, systemic mycosis - 1 or 2 months, candidiasis of the skin and mouth - 2 or 3 weeks, thrush - 5 days.
According to the instructions, Nizoral can also be given to children. For them, the dosage is calculated by weight: children weighing 15-30 kg are given 100 mg/day, for the prevention of fungus - 4-8 mg/kg body weight per day.
Nizoral cream is recommended to be applied to fungal-affected areas once or twice a day. The duration of treatment also depends on the diagnosis. For dermatomycosis, the cream is used for 3-4 weeks, for athlete's foot and athlete's foot - 2-6 weeks, for candidiasis, pityriasis versicolor - 2-3 weeks.
Dandruff is treated with cream for 2-4 weeks.
Nizoral shampoo is used twice a week . To prevent dandruff, you can use shampoo once every two weeks.
To treat lichen versicolor, shampoo is used once every five days.
For a greater therapeutic effect, keep the shampoo on the hair for five minutes after application.
Nizoral vaginal suppositories are used once a day, one suppository for 3-5 days.
Good reviews about Nizoral and its effectiveness for thrush when suppositories and tablets are taken at the same time.
Analogs
Nizoral analogues are substances that have a similar effect on fungal diseases. These include:
- ketoconazole;
- mycozoral;
- mycostine;
- lavisil.
All similar drugs have a detrimental effect on fungi. They are used for both external and systemic treatment. Available in various forms. The cost ranges from 200 to 400 rubles. It depends on the form of release and duration of treatment.
The price of Nizoral ranges from 200 to 500 rubles. Since Nizoral is available in the form of ointments and tablets, the cost depends on what form is required for therapy. In certain cases, the doctor may prescribe complex treatment. It consists of the combined use of tablets and ointment.
