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adapalene vs ketoconazole

Side-by-side comparison of adapalene and ketoconazole Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

Drug Class
adapalene Retinoid (Topical)
ketoconazole Azole Antifungal
Type
adapalene Over-the-Counter
ketoconazole Over-the-Counter
Summary
adapalene

Adapalene and benzoyl peroxide gel is a medicine used on the skin to treat acne. It contains two medicines: adapalene (a retinoid) and benzoyl peroxide.

ketoconazole

Ketoconazole shampoo is an antifungal medicine. It treats a fungal infection on your skin.

What It Treats
adapalene

This medicine treats acne, a skin condition with pimples and bumps. You can use this medicine if you are 9 years or older. Apply the gel to the affected areas of your face and/or trunk.

ketoconazole

This shampoo treats tinea versicolor, a fungal infection. This infection can cause patches on your skin that are lighter or darker than the surrounding skin. These patches may appear on your trunk, neck, arms, and upper thighs.

How It Works
adapalene

Adapalene is a retinoid that helps to unclog pores and reduce inflammation. Benzoyl peroxide is an antibacterial medicine that kills acne-causing bacteria. Together, they help to clear up acne.

ketoconazole

Ketoconazole is an antifungal medicine. It works by stopping the growth of the fungus. This helps to clear up the infection.

Common Side Effects
adapalene
  • Dry skin
  • Contact dermatitis (skin rash)
  • Burning feeling on the skin where you put the medicine
  • Skin irritation
ketoconazole

No common side effects listed.

FAERS Reports
adapalene
  • The medicine did not work 51,276
  • Dry skin 44,990
  • Burning feeling on the skin 41,633
  • Acne 39,264
  • Redness 38,379
ketoconazole
  • The medicine did not work 1,582
  • Using the medicine for something it's not approved for 1,174
  • Feeling tired 929
  • Itching 902
  • Feeling sick to your stomach 834
Serious Warnings
adapalene

When using this medicine, avoid sunlight and sunlamps. If you can't avoid the sun, wear sunscreen. This medicine may cause skin irritation, redness, scaling, dryness, stinging, or burning. If this happens, use a moisturizer or apply the medicine less often. If irritation is severe, stop using the medicine.

ketoconazole

You should not use this shampoo if you are allergic to ketoconazole or any of the other ingredients.

Pregnancy
adapalene

If you are pregnant, only use this medicine if the benefit outweighs the risk to the baby. It is not known if this medicine passes into breast milk, so talk to your doctor before using it if you are breastfeeding.

ketoconazole

It is not known if ketoconazole shampoo can harm an unborn baby. Talk to your doctor if you are pregnant or breastfeeding before using this medicine.

Also Compare — Nearby Drugs

How to Read This adapalene vs ketoconazole Comparison

adapalene is classified in the Retinoid (Topical) drug class, while ketoconazole sits within the Azole Antifungal class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are available over the counter.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, adapalene has 215,542 submissions while ketoconazole has 5,421. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between adapalene and ketoconazole — always consult your physician or pharmacist first.

Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.