Danoff Shampoo
Ketoconazole 1.9%, 2%
Kasturi Pharmaceuticals
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Indications
Danoff Shampoo is used for:
Dandruff, Seborrheic dermatitis of the scalp, Pityriasis versicolor
Adult Dose
Seborrheic Dermatitis
Cream: Apply q12hr for 4 weeks or until clear
Shampoo: Apply twice weekly for 4 weeks, with at least 3 days between each shampoo
Tinea Versicolor
Shampoo
Wet hair, massage into scalp for 1 min, and rinse
Repeat, leaving on scalp for 3 additional min
Shampoo twice weekly for 4 weeks, allowing 3 days between each shampoo
Tinea Corporis, Tinea Cruris, Tinea Pedis
Cream: Apply qDay for 2 weeks (6 weeks for tinea pedis), covering affected area
Child Dose
Seborrheic Dermatitis
<12 years: Safety and efficacy not established
>12 years (shampoo): Apply twice weekly for 4 weeks, with at least 3 days between each shampoo
>12 years (cream): Apply to affected area q12hr x4 weeks
Renal Dose
Administration
To use the Ketoconazole shampoo, follow these steps: Use a small amount of water to wet the area where Ketoconazole shampoo is to be applied. Apply the shampoo to the affected skin/scalp and a large area around it. Use fingers to rub the shampoo until it forms lather. Leave the shampoo on skin/scalp for 5 minutes. Rinse the shampoo off skin/scalp with water.
Contra Indications
Known hypersensitivity to ketoconazole or any of the excipients.
Precautions
In patients who have been on prolonged treatment with topical corticosteroids, it is recommended that the steroid therapy be gradually withdrawn over a period of 2 to 3 weeks, while using Ketoconazole 2% shampoo to prevent any potential rebound effect. Avoid contact with the eyes. If the shampoo enters the eyes, rinse immediately with plenty of water.
Lactation: Not known if distributed into milk; use caution
Pregnancy-Lactation
Interactions
Reduced absorption w/ antimuscarinics, antacids, H2-blockers, PPIs, sucralfate. Reduced plasma concentrations w/ rifampicin, isoniazid, efavirenz, nevirapine, phenytoin. May also reduce concentrations of isoniazid and rifampicin. May reduce efficacy of oral contraceptives. May increase serum levels of CYP3A4 substrates e.g. digoxin, oral anticoagulants, sildenafil, tacrolimus.
Potentially Fatal: May potentiate and prolong sedative and hypnotic effects of midazolam and triazolam. Increased plasma levels and prolonged QT intervals of astemizole, cisapride, dofetilide, pimozide, quinidine and terfenadine which may lead to torsade de pointes. Increased risk of myopathy w/ HMG-CoA reductase inhibitors (e.g. lovastatin, simvastatin). Markedly increased plasma levels of nisoldipine. Increased risk of hyperkalaemia and hypotension w/ eplerenone. Increased risk of vasospasm potentially leading to cerebral ischaemia w/ ergot alkaloids (e.g. ergotamine, dihydroergotamine).
Adverse Effects
Side effects of Ketoconazole 1.9%, 2% :
1-10%
Irritation, severe,Pruritus,Stinging
Frequency Not Defined
Shampoo
Hair loss/alopecia,Irritation,Abnormal hair texture,Scalp pustules,Dry skin,Pruritus,Oiliness/dryness of hair and scalp
Mechanism of Action
Ketoconazole interferes w/ biosynthesis of triglycerides and phopholipids by blocking fungal CYP450, thus altering cell membrane permeability in susceptible fungi. It also inhibits other fungal enzymes resulting in the accumulation of toxic concentrations of hydrogen peroxide.
Note
Danoff Shampoo manufactured by Kasturi Pharmaceuticals. Its generic name is Ketoconazole 1.9%, 2%. Danoff is availble in Nepal.
Farmaco Nepal drug index information on Danoff Shampoo is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.