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Ketoconazole (cream and shampoo)

Brand names: Nizoral, Extina, Xolegel

Ketoconazole cream and shampoo treat dandruff, seborrheic dermatitis, tinea versicolor, and other fungal skin infections.

Brand namesNizoral, Extina, Xolegel
Type of medicineAntifungal
Prescription?Over the counter (1% shampoo); prescription (2% shampoo and cream)
ImportantThis page is general information, not a prescription. Don't start, stop, or change a medicine without talking to your provider or pharmacist.

Overview

Ketoconazole pills are rarely used because of liver risk; this page covers skin and scalp products.

What it's used for

  • Dandruff and seborrheic dermatitis
  • Tinea versicolor
  • Ringworm, athlete's foot, and jock itch

How to take it

  • Shampoo: lather, leave on 3 to 5 minutes, then rinse.
  • Cream: apply to the affected skin and a little beyond, usually once or twice a day.

Your dose depends on your health and other medicines. Always follow your prescription label, and ask your pharmacist if anything is unclear.

Side effects

Common side effects

  • Itching or irritation
  • Dry or oily hair
Call 911Swelling of the face, lips, or throat, hives, or trouble breathing
Call your provider todayBlistering or severe irritation

Warnings

  • Keep out of the eyes.

Other medicines, foods, and alcohol

  • Skin products have few interactions.

Tell your provider and pharmacist about every medicine, vitamin, and supplement you take.

Pregnancy and breastfeeding

Topical use is generally considered low risk. Ask your provider.

Missed doses, overdose, and storage

If you miss a dose

Apply it when you remember, then go back to your usual schedule. Don't apply extra to make up for it.

If someone takes too much

Call Poison Control at 1-800-222-1222 or get help online at poison.org. Call 911 if the person collapses, has a seizure, has trouble breathing, or can't be woken.

Storing it

Store at room temperature, away from heat and moisture (not in the bathroom), and out of reach of children and pets.

Conditions it's used for

Sources

Last updated 2026-11-13.