K TO Z ( LOTION )

• Malassezia fulliculitis dermatophytosis and chronic conditions which cannot be treated topically
• Infections resistant to fluconazole
• Blastomycosis, candidiasis, chromomycosis

Source : IAP Pediatric Drug Formulary
Pityriasis versicolor: use daily for a maximum of 5 days. Seborrhoeic dermatitis and dandruff: use twice weekly for 2-4 weeks Candidiasis, candiduria, or chromomycosis: Oral: Adolescent: 200 mg PO once daily. Serious infection may require 400 mg PO once daily. Children > = 2 years of age: 3.3-6.6 mg/kg PO once daily. Children < 2 years of age: Safety and efficacy have not been established. Oropharyngeal candidiasis (thrush) in HIV-infected children: Oral: Children:3-7 mg/kg/day for 5-49 days till cured Vulvovaginal candidiasis: Nonpregnant adolescent females: 200-600mg PO once daily for 3-6 days. For recurrent vulvovaginal candidiasis, topical or oral therapy daily for 2 weeks then 6 months of therapy that could include ketoconazole 100 mg PO every day. Not recommended in pregnancy Tinea capitis, tinea corporis, tinea cruris, tinea pedis, tinea manuum, tinea unguium(onychomycosis) caused by Trichophyton sp., Adolescent: 200 mg PO once daily. Serious infection may require 400 mg PO once daily. Children > = 2 years of age: 3.3-6.6 mg/kg PO once daily.

Source : NFI National Formulary of India

• Adult- 200 to 400 mg daily once preferably after food.
• Child- (Over 2 years) 3.3 to 6.6 mg/kg body weight once daily after food. Local  application- 3 to 4 times daily, apply thoroughly.

• Hepatic impairment
• Lactation
• Concomitant use with cisapride

• Predisposition to adrenocortical insufficiency
• Avoid in porphyria
• Pregnancy
• Interactions, hepatotoxicity
• Potentially life-threatening hepatotoxicity reported very rarely
• Risk of hepatotoxicity greater if given for longer than 14 days. Monitor liver function before treatment, then on weeks 2 and 4 of treatment, then every month.
• Avoid or use with caution if abnormal liver function tests (avoid in active liver disease) or if history of hepatotoxicity with other drugs.

• Nausea, vomiting, abdominal pain
• Pruritus
• Less commonly diarrhoea, headache, dizziness, drowsiness and rash
• Very rarely, fatal liver damage (see Hepatotoxicity), dyspepsia, raised intracranial pressure, adrenocortical insufficiency, erectile dysfunction, menstrual disorders, azoospermia (with high doses), gynaecomastia, thrombocytopenia, photophobia and alopecia.