Ketoconazole

Nizoral 

Nizoral is an anti-dandruff medication shampoo used to control dandruff. It is the only over-the-counter dandruff-medicated shampoo that contains Ketoconazole. There are various forms of Nizoral, including cream, gel, foam, and shampoo, each with its strengths. However, people might often get confused about the strengths of Nizoral shampoo. Nizoral 2% shampoo is used to treat severe dandruff and serious seborrhoeic dermatitis (a skin condition that affects the scalp). On the other hand, 1% is indicated for the treatment of fungal infections caused by excessive dandruff, as well as providing deep conditioning to the scalp and hair. This FDA-approved over-the-counter medication is suitable for both adults and children, but make sure that you are using this product as your doctor prescribes.   

Product Overview

Nizoral shampoo is a highly effective treatment used for controlling dandruff and seborrheic dermatitis. It contains Ketoconazole, an antifungal medication that targets the root cause of dandruff by slowing down the growth of fungi on the scalp. This potent ingredient, which has been FDA-approved, is recognized for its efficacy in reducing flaking, scaling, and itching associated with dandruff. Unlike many over-the-counter products, Nizoral is available without a prescription, making it accessible for regular use to maintain a healthy scalp.

Nizoral shampoo is available in a 1 and 2% strength formulation, specifically designed for topical application. To use, apply a small amount to the wet scalp, lather, and leave it on for 3-5 minutes before rinsing thoroughly. It is suitable for adults and children over the age of 12. The active ingredient, Ketoconazole, works by disrupting the cell membranes of fungi, effectively controlling dandruff and preventing its recurrence with regular use.

While Nizoral shampoo is generally well-tolerated, some users may notice mild side effects like skin irritation, dryness, or an abnormal texture of hair. To minimize these effects, avoid using other topical medications on the scalp unless directed by a medical expert. If a dose is missed, apply the shampoo as soon as you remember, but avoid using extra to make up for the missed application. In case of a Nizoral overdose or accidental ingestion, seek medical attention immediately. Store Nizoral shampoo at room temperature, away from direct sunlight & moisture, to maintain its effectiveness.

What Are the Uses of Nizoral?

It is used to:

• Control dandruff caused due to dry or greasy scalp and fungal infections.
• Prevent flaking, scaling, and itching on the scalp.

What Are the Forms & Strengths of Nizoral?

Nizoral contains Ketoconazole as its active ingredient that comes in various forms and strengths, which are as follows:

• Cream/Gel/Foam: 2%
• Shampoo: 1 and 2 %

What Are the Recommended Dosage of Nizoral?

The dose of Nizoral shampoo may vary depending on the patient’s condition and the severity. Therefore, it is advisable to follow the instructions as your doctor prescribes. It is important to note that the following dosage recommendations are only the average doses of Nizoral shampoo. If your medical provider prescribed a different dose than the following one, do not alter it unless it has been advised.

Dosage for Dandruff

For Adults and Children 12 Years of Age and Above

• Doctors usually advise to use this medical shampoo every 3 or 4 days for up to 4 weeks. 
• If the condition does not improve within 4 weeks, your doctors may increase the dosage accordingly. 
• If the dandruff returns, use the shampoo once every 1 to 2 weeks.

For Children Below 12 Years of Age

• Consult with a medical provider.

Dosage for White/Brown Patches on the Skin

For Adults and Children 12 Years of Age and Above

• Use the shampoo on the affected area once a day for 5 days. 

For Children Below 12 Years of Age

• Consult with a medical provider.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Use Nizoral?

As the name suggests, Nizoral shampoo is quite easy to use; you just need to be mindful of certain steps while using this medical shampoo:

• Firstly, read the patient information leaflet carefully before you use this shampoo. This step will provide detailed information about the administration steps.
• Follow the doses exactly as your medical practitioner prescribes. Do not exceed or subceed the doses or the number of days for which you have to use this shampoo unless your doctor instructed otherwise. 
• Before applying the shampoo, wet the hair and scalp thoroughly with water. Apply a generous amount of shampoo to produce enough lather and to clean the scalp properly.
• Massage the scalp with a light hand for a minute, leave it for 3 or 5 minutes, and rinse with lukewarm water. 
• You can repeat the process for the second time also if your healthcare provider instructs it.
• Once you are done cleaning your hair and scalp, air dry the hair.
• If you are using this shampoo to treat skin other than the scalp, wet and apply the medication to the infected area and the skin surrounding it. 
• Make enough lather and leave it for 5 minutes, and then rinse it off.
• If you are using OTC or over-the-counter shampoo strengths like 1%, wet the hair, apply the medicated shampoo, lather, and rinse thoroughly. Repeat the process if needed.
• This medication is supposed to be for external use only.
• Do not use the medicated shampoo too often. If you want to wash your hair more often, you can use your usual shampoo.
• If you have thick hair, use your normal shampoo first and then apply the Nizoral shampoo.
• Do not share your medicated shampoo with others, even if they have the same symptoms. Doing so can cause adverse reactions.
• Store Nizoral away from heat, light, and moisture.
• If your condition does not improve or if it worsens over time, tell your healthcare provider. They will surely suggest some alternative options according to your condition. 

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Nizoral Work?

Nizoral shampoo targets malassezia, a fungus found on every individual scalp that causes dandruff. Factors like hormones, climate, stress, and diet can affect growth. Malassezia speeds up the renewal of scalp cells, leading to inflammation, increased cell turnover, and more dead cells, causing itching, flaking, and dandruff. Inflammation can also lead to hair shedding, especially in men with male pattern hair loss. Ketoconazole, the active ingredient in Nizoral shampoo, is an antifungal that kills malassezia. This not only reduces dandruff and itching but also decreases hair loss caused by inflammation, slowing down shedding.

Important Safety Information for Using Nizoral

What Are the Side Effects of Nizoral?

While the FDA has approved Nizoral shampoo, it can have several side effects, like other medications, including both standard and serious effects. Standard or common side effects can last from a few days to weeks. However, if these effects continue to appear more than the mentioned time or bother you or exacerbate, talk to your healthcare practitioner right away. Common side effects of Nizoral may include:

• Textured hair
• Hair/scalp oiliness or dryness 
• Hair discoloration and irritation
• Small bumps like pimples on the scalp
• Dry skin
• Pruritus Of Skin
• Dermatitis
• Alopecia
• Wheezing

Nizoral can also lead to some serious side effects that can be fatal. If you experience any serious side effects during the treatment of Nizoral, tell your medical expert immediately. Serious side effects of Nizoral may include:

• Hair loss
• Severe allergic reaction. Its signs may include:
• Rash
• Itching or swelling on the face, tongue, or throat
• Severe dizziness
• Breathing difficulty
• Scalp pustules
• Application site reaction
• Headache
• Peeling or blistering of the skin 
• Anaphylaxis. Its symptoms may include:
  • Fainting
  • Chest tightness
  • Hoarse voice
  • Diarrhea
  • Difficulty swallowing
  • a feeling of impending doom

Some uncommon effects that may affect a few people:

• Taste impairment
• Hair root infection
• Eye irritation and increases tear production
• Acne
• Unusual hair loss or thinning
• Skin rash or dry, flaky skin
• Skin inflammation
• Skin burning
• Skin redness

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Are There Any Warnings for Nizoral? 

Nizoral may lead to certain adverse effects or may not be a suitable treatment option for every patient due to their medical conditions. So, if you have any of the following conditions or belong to a certain below-mentioned group, talk to a medical professional before starting your treatment with Nizoral anti-dandruff shampoo. Below are some of the warnings:

• Allergic Reactions: Patients using Nizoral (Ketoconazole) shampoo have reported cases of severe hypersensitivity reactions, including anaphylaxis, severe itching, or swelling. If you are allergic to Ketoconazole or any of the ingredients in Nizoral, do not use this shampoo. Its signs may include passing out, chest tightness, hoarse voice, itching, and diarrhea. Stop using it as soon as you notice any of the mentioned signs, and seek medical advice immediately.
• Avoid Eye Contact: Nizoral shampoo can cause eye irritation if it gets into your eyes. Therefore, patients are advised to be cautious when using this shampoo. In case of accidental contact, clean your eyes thoroughly with water to alleviate discomfort.
• Existing Scalp Conditions: If you have pre-existing scalp conditions or skin allergies, consult a healthcare professional before using Nizoral. Doing so ensures the shampoo is safe for your specific health needs.
• Use in Children: Nizoral is not recommended for use in children under 12 years of age. Always consult with an expert physician for appropriate treatments for younger children.

What Are the FDA Boxed Warning for Nizoral?

Boxed or black box warnings are the most stringent warnings issued by the Food and Drug Administration (FDA) for a particular drug that may be dangerous for patients with certain medical conditions. This measure alerts doctors and patients about the harmful effects of the medication. Nizoral has not received any boxed warnings from the FDA. 

What Are the Nizoral Precautions?

Here are some of the precautions that patients need to take or be mindful of when using Nizoral shampoo 2%:

• Before using Nizoral (Ketoconazole) shampoo, talk to a healthcare practitioner and let them know about your active or past allergies or if you are allergic to other azole antifungals, like econazole, clotrimazole, or miconazole. The product may contain certain inactive components that can cause adverse reactions. Talk to an expert for detailed information.
• If you have been using other medications, such as lotions or creams containing steroids, including betamethasone or hydrocortisone, to manage your dandruff or seborrhoeic dermatitis, gradually decrease its use over 2–3 weeks when you start using Nizoral Shampoo. 
• If you are considering using this medication, inform your medical expert about your or your family’s complete medical history. Doing so will prevent you from any mishappenings or serious complications in the future. So, if you have any of the following conditions, talk to a medical physician immediately:
  • Large areas of damaged skin 
  • Allergic reaction to Ketoconazole, other medications, foods, dyes, or preservatives
• Avoid sun exposure while using Nizoral shampoo, as it may make white or brown skin patches more apparent. To reduce this effect, apply your medicated shampoo and use it for three days immediately before sun exposure. This can help minimize the visibility of these patches.
• If you are undergoing surgery or any medical procedure, tell your medical practitioner about the products you use. This includes all prescription drugs, nonprescription drugs, and herbal products.
• Do not alter or abruptly discontinue using the medication without consulting with your healthcare provider. 
• If you are pregnant or planning to have a baby, avoid using this medication unless it is clearly needed. Talk to an experienced healthcare provider and discuss every risk and benefit with them before starting your treatment with this medication.

What Are the Contraindications of Nizoral?

Nizoral shampoo is contraindicated in patients with severe hypersensitivity to the medication’s active ingredients, i.e., Ketoconazole or any of the components used in its formulation.

What If You Missed a Dose of Nizoral?

Generally, patients are advised not to miss any doses or application of their Nizoral shampoo, but if someone forgets to use their shampoo, they can:

• Use the medicated shampoo as soon as possible or whenever you remember.
• If it is almost time for the next application, patients may omit the missed dose and follow their usual dosing schedule as instructed by a medical professional.
• Do not use the Nizoral shampoo twice simultaneously just to catch up for the missed dose. This may cause adverse side effects.
• Use medication apps or set phone reminders to avoid skipping doses.
• Patients can fix the days on which they want to use their medicated shampoo unless directed otherwise. Using the shampoo the same day each time helps avoid skipping doses.
• If you are still uncertain about the missed doses, consult a medical professional. They will guide you and suggest alternate options or treatments.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

What Happens If You Take Too Much of Nizoral?

While patients are educated enough to know the complications of overdose, there are times when they mistakenly put in excessive amounts of Nizoral shampoo. In such cases, people are advised not to panic, be calm, wash their hair as usual, and avoid applying too much shampoo. However, if someone has swallowed Nizoral and is experiencing severe symptoms like fainting and difficulty breathing, visit the nearest clinic or get medical assistance immediately by calling 911.  

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

How to Store a Nizoral?

• Different brands or forms of this medication may require different storage needs. So, read your product’s label or ask your pharmacist for detailed storage information about your particular product. 
• Store the medication at room temperature, and do not keep the product above 25°C.   
• Keep it out of reach and sight of children and pets. 
• Avoid keeping the medication under direct sunlight.
• Store the product away from extreme heat or moisture.
• Do not flush the bottle down the toilet.
• Make sure you store the medicated shampoo somewhere safe to avoid other people using it.
• You can also place a safety lock on the bottle’s cap to avoid poisoning your child.
• Discard the product once it exceeds its expiration date. Certain products mention only the month and year of expiration, which can confuse people about how long they can use the product. For example, if your medication expires on August 2024, you can use the product until the 31st of August 2024.
• Ask a medical expert or your pharmacist how you can dispose of the medication properly without damaging the environment.
• You should dispose of the medications in such a way that children and animals cannot consume them, as it may cause accidental overdose and death if someone else consumes them.
• The best way to eliminate unwanted medications is to give them in the medicine take-back program.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

What Medications Interact with Nizoral?

Drug interactions happen when two or more medications interact with each other. These interactions can happen in two ways. It can either change the medication’s functioning by affecting its ingredients or increase the risks of adverse side effects. Therefore, patients need to be aware of the drugs they take to avoid any complications in the near future. The below drug list does not contain all possible Nizoral drug interactions, but here are some of them:

• Acalabrutinib
• Acarbose
• Acetaminophen
• Acitretin
• Adagrasib
• Bromfenac
• Bromocriptine
• Budesonide
• Carfilzomib
• Cariprazine
• Carmustine
• Danazol
• Danicopan
• Dantrolene
• Eletriptan
• Eliglustat
• Elranatamab
• Eltrombopag
• Fenofibric Acid
• Fenoprofen
• Fentanyl
• Gemcitabine
• Ibrutinib
• Ibuprofen
• Hydroxychloroquine
• Ketoprofen
• Lomitapide
• Lomustine
• Methylprednisolone
• Methyltestosterone
• Nandrolone
• Naproxen
• Oxandrolone
• Oxaprozin
• Pacritinib
• Palbociclib
• Quinidine
• Repotrectinib
• Resmetirom
• Zileuton
• Ziprasidone
• Vardenafil
• Upadacitinib
• Triazolam
• Sulfisoxazole
• Sulindac
• Stanozolol
• Stavudine
• Tamsulosin

What Are the Other Nizoral Interactions?

Other than the drug interactions, Nizoral has a certain disease interactions:

• Hepatotoxicity
• QT prolongation
• Achlorhydria
• Adrenal insufficiency

[Note: This isn’t a complete list, and there could be other drugs that interact with Nizoral. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

What Are the Nizoral Alternatives?

People usually take alternative medicines due to various reasons. In some cases, the prescribed medicine may not be suitable for them due to their medical conditions. On the other hand, maybe they are not getting the results they are aiming for. Therefore, you should talk to a medical professional first before you start a particular treatment or if you want to change your medication. They may help you decide which medication is best suited for you. Some of the alternatives of Nizoral shampoo are as follows:

• • Ketoconazole Shampoos: These medicated shampoos are also over-the-counter products and are available in stronger prescription formulations. Similar to pyrithione zinc shampoos, it works by killing the dandruff-causing fungi. 
    • Ketoconazole topical
    • Xolegel
    • Ketodan
    • Extina
    • Selenium sulfide topical
    • Kuric
  • Pyrithione Zinc Shampoos: This group of medicated shampoos is among the most popular shampoos for dandruff, and it contains the antibacterial and antifungal agent zinc pyrithione. These products are over-the-counter medications whose side effects are uncommon but may sometimes cause mild skin irritation.
    • DermaZinc
    • Aveeno Nourish + Dandruff Control
  • Keratoplastics or Tar-Based Shampoos: Such medications hamper the skin cells’ growth, thus preventing them from turning into flakes and itchiness. Tar-containing shampoos usually have a strong scent and can also stain hair. Therefore, they are not recommended for light-colored hair. 
    • Neutrogena T/Gel
    • DHS Tar Shampoo
  • Shampoos Containing Salicylic Acid: Unlike other shampoos, these products target excess oil production instead of yeast. They are available over-the-counter without needing a prescription. While side effects are uncommon, seek immediate medical attention if you experience a severe skin reaction or signs of an allergic response, including swelling of the lips and tongue.
    • Neutrogena T/Sal
    • Meted
  • Selenium Sulfide Shampoos: These medicated shampoos are available over-the-counter in your nearest pharmacies. While side effects are very rare, patients should take immediate medical assistance if they notice allergic reactions, including troubled breathing, hives, or swelling.
    • Dandrex
    • Selsun Blue
    • Selseb
    • SelRx

• Others

• • Sebuderm
  • Capex
  • Ovace Wash

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

Nizoral Cost & Coupons

It is important to note that the cost of Nizoral dandruff shampoo is not the same everywhere. The actual cost of this medicated shampoo depends on various factors, like your insurance plan, location, and the pharmacies you use. Nizoral, with its effective scalp cleaning quality, can be expensive for some individuals. Here, insurance coverage plays an important role. With an insurance coverage plan, you can buy your shampoo at a discounted price. However, not all drugs or medications are covered under the insurance plan. To manage these costs, you can buy from reputed and licensed pharmacies like Polar Bear Meds, where you can buy Nizoral online from Canada at affordable prices. Moreover, first-time buyers can use the Nizoral coupon code WELCOMEPB10 to receive a 10% discount on their first order.

Frequently Asked Questions

Can I use Nizoral shampoo every day?

Nizoral shampoo is not intended for daily use. It is typically recommended to use it twice a week for effective results. Remember that the doses can vary depending on the patient’s medical condition. Moreover, using it more frequently may lead to scalp irritation or dryness. Follow the directions mentioned on the product’s label or those given by your medical practitioner to ensure the safe and optimal use of Nizoral shampoo for dandruff control.

Does Nizoral shampoo make my hair thicker and strong?

Nizoral shampoo is mainly used to treat dandruff and scalp conditions, not to make hair thicker or stronger. Its main ingredient, Ketoconazole, targets fungal infections that cause dandruff. While it may improve scalp health, any effect on hair thickness or strength is incidental. You may experience hair regrowth, but it is not a common effect. For specific hair thickening or strengthening treatments, consider products specifically formulated for those purposes. Consult an expert medical practitioner for personalized hair growth or thickening treatments.

Can I use my normal shampoo with Nizoral?

Yes, you can use your normal shampoo in combination with Nizoral. It is often recommended to alternate between Nizoral and your regular shampoo. Doctors usually advise using Nizoral twice a week to treat dandruff, and on other days, they recommend using your regular shampoo. This routine can help maintain scalp health and manage dandruff effectively without over-drying your scalp. 

Is it necessary to leave Nizoral shampoo for a few minutes?

Yes, it is necessary to leave Nizoral shampoo on your scalp for a few minutes. After lathering, let it sit for 3-5 minutes before rinsing thoroughly. This allows the active ingredient, Ketoconazole, to effectively target the fungus-causing dandruff. Following this instruction ensures the maximum effectiveness of the treatment and helps manage dandruff symptoms more effectively.

Can I use a normal conditioner after using Nizoral shampoo?

Yes, you can use a normal conditioner after using Nizoral shampoo. After thoroughly rinsing out the Nizoral shampoo, apply your regular conditioner to your hair as you normally would. This can help maintain your hair’s softness and manageability, especially since medicated shampoos like Nizoral can sometimes leave hair feeling dry. Ensure you rinse the conditioner thoroughly for best results. 

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