- Oral ketoconazole should NOT be used for fungal infections of skin and nails as severe hepatotoxicity may occur.
- Oral ketoconazole should only be used for life-threatening fungal infections.
Of note, ketoconazole blocks testosterone synthesis and thus can decrease serum testosterone resulting in gynecomastia, decreased libido, impotence and oligospermia in men. The action of ACTH on cortisol can be inhibited and adrenal insufficiency can result. Hypothyroidism has been reported.
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