Fluconazole or Ketoconazole?

What the Fluconazole or Ketoconazole at a fungus are better?

At a disease of a fungal infection everyone has a need of the choice – drugs in drugstore, but it is necessary to choose that which will help in the shortest possible time and also has as little as possible side effects, half-yen and allylamine drugs. And there are also drugs in other classifications, but are less popular. Therefore the question of the rational choice from this set of drugs is unsurprising. The most popular drugs are azoles which include such drugs as the Fluconazole or Ketoconazole, patients often have a choice between these drugs.

What to choose the Fluconazole or Ketoconazole?

As both drugs belong to one group of antimycotic means, there is a question of what of drugs is better and whether it is possible to combine these medicines when performing complex anti-fungal therapy. Most of doctors consider that this medicine should not be taken in common, similar therapy is capable to increase risk of emergence of side effects and to affect negatively on the general state of health of the patient suffering from a mycotic infection. At comparison of these two medicines the difference an essential difference in the price is visible. Ketoconazole has the price within $2.5 – 3.5, and the Fluconazole of only $1.5-2. Both means have a broad spectrum of activity and have pronounced properties. Both drugs are not recommended to be used for performing therapy during pregnancy and a lactation.

Each of these drugs has a small amount of side effects, and it is not necessary to combine them.

Short characteristic of Ketoconazole, property and structure.

The active agent of the same name which fights against many types of fungal activators is a part of Ketoconazole. Its action is based that Ketoconazole – oppresses a cell wall of a fungus, thereby the activator loses a blanket and perishes. It is effective against such fungi as Candida, Aspergilla, Histoplasma, Trikhofitum and Epidermofitie. The range of its action is extremely wide that allows to appoint it in the heaviest and combined cases.

The drug orally is taken, necessary concentration and action begins in 4-5 hours. The effective half-life makes 15-17 hours. In order that concentration remained stable a long time and fight against a virus did not stop, it is necessary to drink drug regularly, doing not pass and increasing a dose. In blood concentration increases gradually, reaching a maximum 6 hours later. Drug will be transformed in a liver, at the same time is transferred by special proteins. Feature of medicine is its storage in cells which are rich with a keratin, to it skin, hair and nails belongs. Gradually drug leaves fabrics, it depends on what speed of skin regeneration at the person. In a nail drug is capable to remain for 3 and more months, in nails of toes medicine remains within 6 months. In skin cells the drug preservation period much less is also no more than two weeks.

Important! In cells of mucous membranes term is no more than three days.

Ketoconazole apply in dermatology and ophthalmology. The main indication at which Ketoconazole is appointed is fungal infection of an integument, a hair, nails and mucous membranes of a throat, and also at the thrush, especially at diseases of a vagina and intestines.

Ketoconazole is used at system fungal pathologies, for example at mycoses of internals. At mycotic meningitis drug is appointed as a reserve. A drug route of administration – peroral. The greatest efficiency of drug occurs in skin.

It is necessary to accept medicine on 2 capsules twice a day, within a month. After that it is necessary to take surely a break in reception in order that the liver restored the functionality, and also to avoid overdose. If the patient has serious associated diseases of the immune system, it is necessary to increase a dose to prevent a recurrence.

It is necessary to accept Ketoconazole surely after meal, it is desirable vitamin-rich and microelements, products the containing fats – meat, fish, nuts.

Ketoconazole can influence the different systems of an organism, such as:

  • Central nervous system. Can be followed by unpleasant feelings in a forehead or a nape.
  • An allergy to any component of drug, the phenomena of an intolerable skin itch are also frequent.
  • Defeat of bodies of the alimentary system can be shown by such signs.
  • Changes from blood.
  • Negative impacts on cytochromes of cells of the person are possible.

Patients with problems of a liver should not take this drug, it can contribute to the development of hepatitis, cirrhosis or liver failure.

The taking place defeat of acoustic organs and sight are in addition possible – after the medicine use termination these symptoms disappear.

The short description of the Fluconazole – pharmacological properties and structure

The Fluconazole is an anti fungal drug which, as well as Ketoconazole, possesses a wide range of activity against fungal activators.

The mechanism of effect of active agent – oppression of a cell wall and enzymes of a microorganism that leads to death of a virus. High concentration of medicine in leather and fabrics allows to prevent reproduction of a fungus. Affects more selectively fungus cells, unlike Ketoconazole.

It is used as anti fungal reserve means. It means that the Fluconazole is used at the most serious states, such as fungal infection of internals. Also it is effective when carrying out chemo radiation radiation therapy at patients with malignant processes. It is well combined with antibiotics and cytostatics. The best effect gives in a combination with terbinafin.

At reception of the Fluconazole there is no need to eat high-calorie food. It is possible to accept it after a meal or on an empty stomach. Unlike Ketoconazole, it not so actively communicates proteins of plasma, but, nevertheless, is also transformed in a liver. The highest concentration of drug is reached to third day of reception, however in the first administration of drug the double dose is necessary. It allows to liquidate a large number of the activator for once.

In blood and other liquids, concentration of drug is identical. It needs to be considered when treatment is done during pregnancy and feeding by a breast. It is necessary to consider risks for mother and a fruit, and only after that to appoint therapy.

The highest concentration of drug appears in skin, hair and nails. Drug in them collects gradually, equally, as well as is removed. Skin medicine comes out a week later after the reception termination, nails – within six months.

Removal of drug through kidneys provides an effective half-life at the level of 25 hours.

At people with an impaired renal function and urination, this process it is broken and extended.

Features of use of the drug Fluconazole

The main indication for purpose of this drug is the massive or deep fungal infection of skin, its appendages or internals. Drug works even in such difficult cases as fungal meningitis. At sepsis this drug is widely used as the main method of treatment. At patients with acquired immunodeficiency syndrome this medicine is used as constant prophylactic which prevents massive reproduction of fungal microorganisms.

Fluconazole apply when carrying dentures when there is a danger development of a fungal infection. Those people who have a real or liver failure need to take the drug extremely carefully not to provoke development of an end-stage of a disease. During pregnancy it is better to refrain from drug or to replace it with safer analog.

Side effects which medicine can cause:

  • The sharp abdominal pains which are not connected with meal vomiting without nausea, constipation is possible.
  • Frequent symptoms from the central nervous system is the headache and dizziness.
  • The allergy to drug is considered very dangerous side effect – it can be both a laryngeal edema, and massive skin reaction with rejection of epidermis.
  • In the presence of heart diseases, such as ischemic disease or hypertension drug can cause disturbances of a rhythm and change of a voltage. It is felt as a stethalgia, feeling of shortage of air, tachycardia, heartbeat.
  • The hair loss after long administration of drug can develop.


Both drugs are contraindicated to people who have allergic predisposition, to one or several components of drugs. In this case it is better to replace drug with another, with the structure similar on action, but another on structure.

Both drugs are similar in the actions, and it to accumulation of active agent in integuments.

Fluconazole is brought out of an organism quicker, and also it has smaller side effect less negative impact on an organism.

Also Fluconazole is cheaper than Ketoconazole, it is a part of the popular drug Diflucan.

The given comparisons cannot bear advisory nature, the independent choice of drug can be dangerous, as well as self-treatment. You will surely consult with the doctor.

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