fluconazole vs ketoconazole
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
Side-by-side comparison of fluconazole and ketoconazole. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Diflucan
Nizoral
Fluconazole is an antifungal medicine. It is used to treat infections caused by fungus.
Ketoconazole shampoo is an antifungal medicine. It treats a fungal infection on your skin.
Fluconazole treats vaginal yeast infections. It also treats yeast infections in the mouth and esophagus. Fluconazole can also treat urinary tract infections, peritonitis, systemic Candida infections, and pneumonia. It can also treat cryptococcal meningitis. Fluconazole can also prevent candidiasis in patients undergoing bone marrow transplantation.
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.
Fluconazole works by stopping the growth of fungi. It blocks the fungus from producing a substance it needs to grow. This helps to clear up the infection.
Ketoconazole is an antifungal medicine. It works by stopping the growth of the fungus. This helps to clear up the infection.
- • Headache
- • Nausea
- • Abdominal pain
No common side effects listed.
- Pyrexia 4,121
- Nausea 3,697
- Diarrhoea 3,538
- Fatigue 3,151
- Pain 3,123
- Fatigue 929
- Pruritus 902
- Nausea 834
- Rash 802
- Diarrhoea 760
Coadministration of other drugs known to prolong the QT interval and which are metabolized via the enzyme CYP3A4 such as erythromycin, pimozide, and quinidine are contraindicated in patients receiving fluconazole.
You should not use this shampoo if you are allergic to ketoconazole or any of the other ingredients.
Tell your doctor if you are pregnant or plan to become pregnant. Fluconazole may not be safe for your baby. Talk to your doctor about breastfeeding while taking fluconazole.
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.
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How to Read This fluconazole vs ketoconazole Comparison
fluconazole is classified in the Azole Antifungal drug class, while ketoconazole sits within the Azole Antifungal class. Because both drugs share the same classification, they are often considered interchangeable in theory, but clinical outcomes rarely track that cleanly. 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, fluconazole has 17,630 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. 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 represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for fluconazole or ketoconazole.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.