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dexamethasone vs ketoconazole

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

moderate Known Drug Interaction

Drugs which inhibit CYP 3A4 (e.g., ketoconazole, macrolide antibiotics such as erythromycin) have the potential to result in increased plasma concentrations of corticosteroids. Ketoconazole: Ketoconazole has been reported to decrease the metabolism of certain corticosteroids by up to 60%, leading to increased risk of corticosteroid side effects. In addition, ketoconazole alone can inhibit adrenal corticosteroid synthesis and may cause adrenal insufficiency during corticosteroid withdrawal.

Recommendation: Your doctor may need to lower your steroid dose or watch you closely for side effects while you are taking both medicines.

Drug Class
dexamethasone Corticosteroid
ketoconazole Azole Antifungal
Type
dexamethasone Prescription
ketoconazole Over-the-Counter
Summary
dexamethasone

Dexamethasone (Decadron) is a corticosteroid medicine. It helps reduce inflammation and suppress the immune system.

ketoconazole

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

What It Treats
dexamethasone

This medicine treats many conditions, including allergies, skin problems, and breathing issues. It can also help with certain cancers, hormone problems, and nervous system disorders. Dexamethasone can also be used for short-term relief of arthritis and other joint problems.

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
dexamethasone

Dexamethasone works by decreasing inflammation in the body. It also changes how your immune system works. This can help reduce symptoms of various conditions.

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
dexamethasone
  • Increased appetite
  • Weight gain
  • Fluid retention
  • Mood swings
  • Insomnia
ketoconazole

No common side effects listed.

FAERS Reports
dexamethasone
  • Feeling very tired 16,525
  • Loose, watery stools 16,517
  • A type of cancer affecting plasma cells 13,768
  • Feeling sick to your stomach 13,498
  • Lung infection 13,291
ketoconazole
  • Feeling tired 929
  • Itching 902
  • Feeling sick to your stomach 834
  • Skin breakout 802
  • Loose stool 760
Serious Warnings
dexamethasone

If you have a systemic fungal infection, you should not take this medicine. Long-term use can also make it harder for your body to respond to stress.

ketoconazole

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

Pregnancy
dexamethasone

Talk to your doctor if you are pregnant or breastfeeding before taking this medicine. Dexamethasone may harm an unborn baby. It can also pass into breast milk.

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 dexamethasone vs ketoconazole Comparison

dexamethasone is classified in the Corticosteroid 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 split between OTC and prescription status, which affects access and supervision.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, dexamethasone has 73,599 submissions while ketoconazole has 4,227. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known moderate interaction flagged in FDA labeling, attributed to ketoconazole slows down how your body breaks down the steroid, which can cause the medicine to build up to high levels. this increases your risk of having serious side effects from the steroid.. 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 dexamethasone 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.