ketoconazole vs terbinafine
Side-by-side comparison of ketoconazole and terbinafine. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
minor Known Drug Interaction
Based on this finding, it is likely that other inhibitors of both CYP2C9 and CYP3A4 (e.g., ketoconazole, amiodarone) may also lead to a substantial increase in the systemic exposure (C max and AUC) of terbinafine when concomitantly administered.
Recommendation: Your doctor may need to adjust your terbinafine dose or monitor you more closely for side effects.
Nizoral
Lamisil
Ketoconazole shampoo is an antifungal medicine. It treats a fungal infection on your skin.
Terbinafine is an antifungal medicine. It is used to treat fungal infections of the fingernails and toenails.
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.
Terbinafine treats onychomycosis, a fungal infection of the toenails or fingernails. Before you start taking this medicine, your doctor should take a nail sample. This is to make sure the infection is caused by a fungus.
Ketoconazole is an antifungal medicine. It works by stopping the growth of the fungus. This helps to clear up the infection.
Terbinafine belongs to a class of medicines called allylamine antifungals. It works by stopping the growth of fungi. This eventually kills the fungus causing the infection.
No common side effects listed.
- • Headache
- • Diarrhea
- • Rash
- • Upset stomach
- • Abnormal liver enzyme tests
- Feeling tired 929
- Itching 902
- Feeling sick to your stomach 834
- Skin breakout 802
- Loose stool 760
- Skin rash 391
- Itching 316
- Tiredness 300
- Feeling sick to your stomach 280
- Loss of taste 270
You should not use this shampoo if you are allergic to ketoconazole or any of the other ingredients.
Terbinafine can cause liver problems, including liver failure. Your doctor should check your liver before you start taking it and regularly while you are taking it. Tell your doctor right away if you have nausea, loss of appetite, tiredness, vomiting, pain in your upper right belly area, yellowing of the skin or eyes, dark urine, or pale stools. If you have taste changes, stop taking terbinafine. These changes can be severe, long-lasting, or even permanent. Tell your doctor if you feel depressed or have other mood changes.
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.
Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if terbinafine will harm your unborn baby. Terbinafine passes into breast milk. Talk to your doctor about the risks and benefits of breastfeeding while taking this medicine.
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How to Read This ketoconazole vs terbinafine Comparison
ketoconazole is classified in the Azole Antifungal drug class, while terbinafine sits within the Allylamine 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, ketoconazole has 4,227 submissions while terbinafine has 1,557. 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 minor interaction flagged in FDA labeling, attributed to ketoconazole stops the body from breaking down terbinafine, which can lead to much higher levels of terbinafine in your blood.. 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 ketoconazole and terbinafine - 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.