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Medication details

  • Medication type: Antifungal
  • Form: Liquid, Capsule, Tablet, Topical
  • Prescription required? Yes
  • FDA approved? No
  • Brand names: Nizoral
  • Common names: Ketoconazole
  • Available dosages: Liquid: 50mg/mL and 100mg/mL; Capsules: 15mg, 25mg, 30mg, 35mg, 40mg, 50mg, 100mg, 150mg, 250mg, 300mg, 400mg; Tablets: 200mg; Topical Solutions: 0.15%, 1%
  • Expiration range: Varies based on product type; refer to package label for specific expiration date

If your dog has ever been diagnosed with a fungal infection, chances are they may have received a medication called ketoconazole to treat their condition. 

Historically, ketoconazole has been widely used in veterinary medicine due to its effectiveness against a broad range of fungi. In recent years, its use has decreased due to other available antifungals with less side effects, but it is still a great option for many dogs. 

Read on to learn more about ketoconazole for dogs and how it may benefit your pet. 

What Is Ketoconazole?

Ketoconazole is an antifungal medication used to treat a variety of fungal infections in dogs. Although the medication is FDA-approved for use in humans, it is not yet approved in dogs. However, many veterinarians practice “extra-label” prescribing of ketoconazole to dogs. This simply means the medication is prescribed outside of its approved use according to the drug label. This is a common and acceptable practice in veterinary medicine for many types of medications. 

Ketoconazole is available in both generic and brand name forms by prescription only. It is readily available at most primary care veterinary hospitals throughout the United States. 

What Does Ketoconazole for Dogs Look Like?

Ketoconazole tablets for dogs vary in appearance depending on the manufacturer and dispensing pharmacy. However, they are typically round tablets that are white to tan in color. Many have score lines present for ease of dosing. The medication can be compounded into a capsule with an outer coating that is two-toned in color, a flavored liquid with an oily consistency, or an orange, chicken-flavored chew. 

Ketoconazole also comes in many topical forms. The liquid form, which is clear in color, can be added to ear wash, ointments, creams, and wipes.

How Does Ketoconazole Work?

Ketoconazole tablets

Ketoconazole is part of the class of antifungals called azoles. Its main function is to prevent the fungal cell wall from forming and functioning properly. This interferes with the infectious potential of the fungus. 

Ketoconazole can also decrease testosterone production by binding to important receptors in the body, which can result in male infertility in dogs. It also reduces steroid hormone production by the adrenal glands, which are increased in dogs with Cushing’s disease

What Is Ketoconazole Used For in Dogs?

Ketoconazole is used to treat a variety of health conditions in dogs. It is primarily used to treat systemic and localized fungal infections. However, one of its side effects—to block cortisol production from the adrenal glands—is used to treat Cushing’s disease. Additional conditions that ketoconazole is effective against include the following: 

How to Give Ketoconazole for Dogs

To treat systemic fungal infections, ketoconazole is administered orally. It is readily available in tablet form, but it can also be compounded into a liquid or capsule for easier administration by pet parents. Disguising the medication in a pill pocket or a “meatball” of wet food can help entice dogs to take the medication.

For skin and ear infections, ketoconazole is generally applied topically. Available products containing ketoconazole include ointments, creams, shampoos, wipes, sprays, and ear flush for dogs. In severe infections or those that do not respond to these treatments alone, topical products may need to be combined with oral medication for full resolution. 

Ketoconazole Side Effects in Dogs

Ketoconazole has several side effects pet parents should be aware of. Most are mild, but in rare instances, serious side effects can occur. Pet parents should watch for the following signs: 

  • Vomiting 
  • Diarrhea
  • Decreased appetite 
  • Reduced energy 

Long-term use of ketoconazole can result in liver damage. More severe side effects may include the following:  

  • Yellowing of the skin, gums, and eyes
  • Increased thirst
  • Increased urination
  • Weight loss 
  • Seizures 

All dogs receiving oral ketoconazole for an extended period of time should receive regular blood work to monitor their liver enzymes and blood cell counts. This medication should not be used in dogs with pre-existing liver disease or in pregnant or nursing dogs. 

Reactions With Other Drugs and Medications

Ketoconazole does interact with many other medications used in dogs. A few examples of these medications include macrolide antibiotics, ivermectin, cyclosporine, and cisapride. Always let your dog’s veterinarian know all over-the-counter and prescription medications or supplements your dog is currently taking. Your veterinarian can advise you on whether or not ketoconazole would be a safe medication to take alongside your dog’s current regimen. 

Ketoconazole Dosage for Dogs

The dose of ketoconazole varies based on a dog’s size. Treatment length depends on the underlying condition present and usually extends past the resolution of symptoms. Always follow your veterinarian’s recommendations and give the medication exactly as prescribed for the best outcome. Ketoconazole should always be administered with food. 

What If My Dog Misses a Dose of Ketoconazole?

If your dog misses a dose of ketoconazole, do not double up. Give the next dose at the correct time and continue giving the medication as previously prescribed. If missing doses happens repeatedly, speak with your pet’s veterinarian to see if there are alternative treatment options that may be a better fit.                         

Ketoconazole for Dogs Cost

The cost of ketoconazole varies among veterinary practices in different parts of the country. Generic forms of the medication are much less expensive than name brands. Pet parents should anticipate spending between $30-$60 for a three-week course of oral tablets. Some fungal infections will resolve in this time frame while others require much longer treatment, which will further increase costs. Compounded liquid or capsules are more expensive than tablets because they must be prepared by a special pharmacy. Topical medications range from $15-$50. For dogs taking ketoconazole long-term, blood work monitoring can cost between $50-$100. 

Ketoconazole Storage Instructions 

Ketoconazole products should be stored at room temperature out of direct sunlight. Tablets, capsules, and liquid should be stored in a container that is tightly closed and protected from moisture. Sprays, wipes, creams, ointments, and shampoos should be kept closed when not in use. All products containing ketoconazole should be kept out of reach of children and other pets.