Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Ketoconazole
Drug ID BADD_D01230
Description Ketoconazole is an imidazole antifungal agent used in the prevention and treatment of a variety of fungal infections.[FDA Label] It functions by preventing the synthesis of ergosterol, the fungal equivalent of cholesterol, thereby increasing membrane fluidity and preventing growth of the fungus.[A181802,T116] Ketoconazole was first approved in an oral formulation for systemic use by the FDA in 1981.[A188054] At this time it was considered a significant improvement over previous antifungals, [miconazole] and [clotrimazole], due to its broad spectrum and good absorption. However, it was discovered that ketoconazole produces frequent gastrointestinal side effects and dose-related hepatitis.[A188054,A188057] These effects combined with waning efficacy led to its eventual replacement by triazole agents, [fluconazole], [itraconazole], [voriconazole], and [posaconazole]. Ketoconazole and its predecessor [clotrimazole] continue to be used in topical formulations.
Indications and Usage For the treatment of the following systemic fungal infections: candidiasis, chronic mucocutaneous candidiasis, oral thrush, candiduria, blastomycosis, coccidioidomycosis, histoplasmosis, chromomycosis, and paracoccidioidomycosis.
Marketing Status Prescription; OTC; Discontinued
ATC Code D01AC08; G01AF11; H02CA03; J02AB02
DrugBank ID DB01026
KEGG ID D00351
MeSH ID D007654
PubChem ID 3823
TTD Drug ID D0B4IF
NDC Product Code 68788-7755; 51927-3194; 50090-1220; 52286-0009; 61919-841; 60524-000; 71335-1652; 43538-530; 38779-0279; 0395-8039; 63629-8675; 51407-279; 68981-023; 51672-1298; 68788-9915; 63629-8677; 70518-3367; 71335-1849; 66267-400; 68071-1614; 70518-2831; 71713-097; 53002-8150; 51927-0065; 72189-180; 68071-1709; 72789-052; 43063-882; 65085-0028; 50090-1675; 71335-0439; 0378-8136; 68071-1735; 43538-531; 0093-3219; 16110-080; 51552-0627; 51672-4026; 68788-9903; 45802-532; 63629-8676; 0168-0099; 59349-0001; 45802-465; 55505-192; 10695-071; 60429-020; 64380-827; 71085-008; 63187-774; 63646-010; 66478-0145; 35573-433; 50090-1992; 62991-1461; 53069-0390; 50090-1524; 63629-8819; 50090-3288; 16714-955; 50090-5265; 49452-3913; 71205-105; 70518-2315; 70518-0762; 63629-8820; 50090-0720; 68071-2309; 71052-490
Synonyms Ketoconazole | R-41400 | R 41400 | R41400 | R41,400 | Nizoral
Chemical Information
Molecular Formula C26H28Cl2N4O4
CAS Registry Number 65277-42-1
SMILES CC(=O)N1CCN(CC1)C2=CC=C(C=C2)OCC3COC(O3)(CN4C=CN=C4)C5=C(C=C(C=C5)Cl)Cl
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Adverse drug reactionCytochrome P450 3A4P08684T378488805725; 8805726; 7489857; 8614120
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Abdominal discomfort07.01.06.0010.000821%Not Available
Abdominal distension07.01.04.0010.000657%
Abdominal pain07.01.05.0020.001314%
Abdominal pain upper07.01.05.003--
Acute febrile neutrophilic dermatosis23.03.03.033; 01.02.01.0060.000493%Not Available
Adrenal insufficiency14.11.01.004; 05.01.02.0010.001314%
Alanine aminotransferase increased13.03.01.0030.000986%
Alcohol intolerance14.02.01.001--
Alopecia23.02.02.0010.001314%
Anaphylactic reaction24.06.03.006; 10.01.07.0010.000329%
Anaphylactic shock10.01.07.002; 24.06.02.004--Not Available
Anaphylactoid reaction24.06.03.007; 10.01.07.0030.000657%Not Available
Angioedema23.04.01.001; 10.01.05.0090.000329%Not Available
Application site pain12.07.01.004; 08.02.01.004--Not Available
Application site reaction08.02.01.006; 12.07.01.006--Not Available
Arrhythmia02.03.02.001--Not Available
Arthralgia15.01.02.001--
Aspartate aminotransferase increased13.03.01.0060.000329%
Asthenia08.01.01.0010.000657%Not Available
Atrioventricular block02.03.01.0020.000329%Not Available
Atrioventricular block complete02.03.01.0030.000657%
Azoospermia21.03.03.001--
Blister23.03.01.001; 12.01.06.0020.000329%Not Available
Blood bilirubin increased13.03.01.0080.000493%
Blood creatine phosphokinase increased13.04.01.0010.000329%
Blood creatinine increased13.13.01.0040.000986%
Blood triglycerides increased13.12.03.001--Not Available
Body temperature increased13.15.01.001--Not Available
Bradycardia02.03.02.0020.000493%Not Available
Breast discharge21.05.05.0010.000329%Not Available
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