Keep this medicine away from the eyes.

For patients using the cream form of this medicine:

• Apply enough ketoconazole cream to cover the affected and surrounding skin areas, and rub in gently.
• To help clear up your infection completely, it is very important that you keep using ketoconazole cream for the full time of treatment, even if your symptoms begin to clear up after a few days. Since fungus or yeast infections may be very slow to clear up, you may have to continue using this medicine every day for up to several weeks. If you stop using this medicine too soon, your symptoms may return. Do not miss any doses.

For patients using the 1% shampoo form of this medicine:

• Wet your hair and scalp well with water.
• Apply enough shampoo to work up a good lather and gently massage it over your entire scalp.
• Rinse your hair and scalp with warm water.
• Repeat application.
• Rinse your hair and scalp well with warm water, and dry your hair.

For patients using the 2% shampoo form of this medicine:

• Wet your hair and scalp well with water.
• Apply the shampoo to the skin of the affected area and a wide margin surrounding this area.
• Work up a good lather and leave it in place for 5 minutes.
• Rinse your hair and scalp well with warm water, and dry your hair.

Dosing

The dose of topical ketoconazole will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of topical ketoconazole. If your dose is different, do not change it unless your doctor tells you to do so.

The number of doses you use each day, the time allowed between doses, and the length of time you use the medicine depend on the medical problem for which you are using topical ketoconazole.

• For cream dosage form:
  • For cutaneous candidiasis, tinea corporis, tinea cruris, tinea pedis, or pityriasis versicolor:
    • Adults Apply once a day to the affected skin and surrounding area.
    • Children Use and dose must be determined by your doctor.
  • For seborrheic dermatitis:
    • Adults Apply two times a day to the affected skin and surrounding area.
    • Children Use and dose must be determined by your doctor.
• For 1% shampoo dosage form:
  • For dandruff:
    • Adults Use every 3 or 4 days for up to 8 weeks. Then use only as needed to keep dandruff under control.
    • Children Use and dose must be determined by your doctor.
• For 2% shampoo dosage form:
  • For pityriasis versicolor:
    • Adults Use once.
    • Children Use and dose must be determined by your doctor.

Missed dose

If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For topical ketoconazole, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to ketoconazole, miconazole or other imidazoles, or sulfites. The cream form of ketoconazole contains sulfites. Also tell your health care professional if you are allergic to any other substances, such as preservatives or dyes.

Pregnancy Ketoconazole has not been studied in pregnant women. However, studies in animals have shown that ketoconazole causes birth defects or other problems. Before using this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding It is not known whether topical ketoconazole, used on a regular basis, is absorbed into the mother's body enough to pass into the breast milk. However, the cream was not absorbed through the skin after a single dose was applied to the chest, back, and arms of volunteers. Also, the shampoo was not absorbed through the skin after frequent shampooing by volunteers. Therefore, it is unlikely to cause problems in nursing babies.

Children Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of this medicine in children with use in other age groups.

Older adults Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of topical ketoconazole in the elderly with use in other age groups.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are using any other prescription or nonprescription (over-the-counter [OTC]) medicine.