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ketoconazole Side Effects

Also known as: Nizoral

Analysis of 16,231 adverse event reports submitted to the FDA from 2004 to 2025.

Total Reports

16,231

Death-Related

1,079

6.6% of reports

Hospitalizations

3,676

22.6% of reports

Top Indication

Product Used For Unknown Indication

Most Reported Adverse Reactions

DRUG INEFFECTIVE
1,582
OFF LABEL USE
1,174
FATIGUE
929
PRURITUS
902
NAUSEA
834
RASH
802
DIARRHOEA
760
PAIN
727
HEADACHE
708
PSORIASIS
645
DYSPNOEA
601
DIZZINESS
589
PRODUCT USE IN UNAPPROVED INDICATION
548
ARTHRALGIA
541
CHRONIC KIDNEY DISEASE
520
ASTHENIA
472
ANXIETY
469
CONDITION AGGRAVATED
448
VOMITING
445
FALL
429

Who Reports Side Effects

Gender Distribution

Female 7,430 (51%)
Male 7,100 (49%)
Unknown 56

Age Distribution

0-17 398 (4%)
18-44 1,977 (21%)
45-64 3,146 (34%)
65-74 1,979 (21%)
75+ 1,717 (19%)

Reporting Trend by Year

2004 2025

Reactions in Death Reports

Top reactions reported in 1,079 reports where death was an outcome. These are voluntarily reported and do not establish causation.

Reaction Reports
DEATH 415
OFF LABEL USE 79
RENAL FAILURE 78
PNEUMONIA 72
DYSPNOEA 65
ACUTE KIDNEY INJURY 60
DRUG INEFFECTIVE 57
ASTHENIA 55
NAUSEA 54
ANAEMIA 52
PYREXIA 51
CHRONIC KIDNEY DISEASE 50
DIARRHOEA 47
PAIN 46
FATIGUE 44
RESPIRATORY FAILURE 42
DISEASE PROGRESSION 39
SEPSIS 39
CARDIO-RESPIRATORY ARREST 38
CARDIAC ARREST 36

Reactions in Hospitalization Reports

Top reactions in 3,676 reports where hospitalization was an outcome.

Reaction Reports
DYSPNOEA 278
FATIGUE 276
PNEUMONIA 258
DIARRHOEA 248
NAUSEA 246
FALL 235
PAIN 234
ASTHENIA 232
ACUTE KIDNEY INJURY 205
DIZZINESS 203
DRUG INEFFECTIVE 192
OFF LABEL USE 192
RENAL FAILURE 188
PYREXIA 183
VOMITING 182
HEADACHE 164
DRUG INTERACTION 160
URINARY TRACT INFECTION 158
WEIGHT DECREASED 147
ANAEMIA 146

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What the FAERS Data Reveals About ketoconazole Side Effects

The FDA Adverse Event Reporting System (FAERS) contains 16,231 voluntary reports linked to ketoconazole and its brand equivalents (Nizoral), spanning 2004 through 2025. Of those, 1,079 (6.6%) listed death as an outcome and 3,676 (22.6%) involved hospitalization. The most common indication reported alongside adverse events was Product Used For Unknown Indication.

Demographic breakdowns help contextualize who is being exposed to the drug. Of reports with known sex, 51% were female and 49% male; age distribution skews toward 45-64, with 3,146 reports in that bracket. The single most reported reaction is drug ineffective with 1,582 submissions, followed by off label use and fatigue.

FAERS is a signal-detection tool, not a scorecard. Reports are voluntary, and a single case may list multiple suspect drugs, so numbers above should not be read as incidence rates or per-patient risk. Widely prescribed drugs naturally accumulate more reports than niche therapies even when individual risk is low. These aggregates are useful for spotting patterns that merit further pharmacovigilance, not for choosing between medications. This page is for educational reference only and is not medical advice — speak with a licensed clinician about any side-effect concerns.