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Ketoconazole Cream vs. Clotrimazole Cream: Dosage, Side Effects

Ketoconazole cream vs. clotrimazole cream: What’s the difference?

  • Ketoconazole cream and clotrimazole antifungal medications are prescribed to treat fungal infections such as jock itch, athlete's foot, ringworm, and tinea versicolor.
  • Brand names for ketoconazole include Nizoral, Nizoral A-D, Ketodan, Extina, Xolegel, and Kuric.
  • Brand names for clotrimazole include Lotrimin AF, Gyne-Lotrimin, Alevazol, and Desenex.
  • Side effects of ketoconazole and clotrimazole that are similar include nausea, vomiting, and itching.
  • Side effects of ketoconazole that are different from clotrimazole include rash, abdominal pain, headache, dizziness, fatigue, impotence, and blood count abnormalities.
  • Side effects of clotrimazole that are different from ketoconazole include local redness, stinging, blistering, peeling, swelling, hives, or burning at the area of application.

What are ketoconazole cream and clotrimazole cream?

Ketoconazole cream is an azole antifungal drug. It belongs to the same family of drugs as fluconazole (Diflucan), miconazole (Micatin, Monistat), and itraconazole (Sporanox). Ketoconazole prevents growth of several types of fungi by preventing production of the membranes that surround fungal cells. Ketoconazole cream is prescribed to treat fungal infections such as ringworm, jock itch, athlete's foot, dandruff, and tinea versicolor.

Clotrimazole cream is an antifungal medication related to fluconazole (Diflucan), ketoconazole (Nizoral), itraconazole (Sporanox), and miconazole (Micatin, Monistat). It prevents growth of several types of fungi by interfering with the production of the membrane that surrounds fungal cells. It is used topically on the skin or inserted vaginally to treat local fungal infections due to Candida albicans, including vaginal yeast infections, tinea versicolor, tinea pedis ("athlete's foot"), tinea cruris ("jock itch"), or tinea corporis (ringworm).


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What are the side effects of ketoconazole cream and clotrimazole cream?

Ketoconazole cream

Stinging, swelling, irritation, or redness of the treated skin may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur:

  • Blistering
  • Open sores

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include:

  • Rash
  • Itching or swelling (especially of the face, tongue, and throat)
  • Severe dizziness
  • Trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Clotrimazole cream

The most commonly noted side effects associated with clotrimazole include:

  • local redness,
  • stinging,
  • blistering,
  • peeling,
  • swelling,
  • itching,
  • hives, or
  • burning at the area of application.

Other side effects include nausea and vomiting, which may be caused by the oral forms.

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What is the dosage of ketoconazole cream vs. clotrimazole cream?

Ketoconazole cream

  • Apply ketoconazole cream 2% once daily to cover the affected and immediate surrounding area. You may see clinical improvement fairly soon after treatment; however, candidal infections and tinea cruris and corporis should be treated for two weeks in order to reduce the possibility of recurrence.
  • Patients with tinea versicolor usually require two weeks of treatment.
  • Patients with tinea pedis require six weeks of treatment.
  • Seborrheic dermatitis: Apply ketoconazole cream 2% to the affected area twice daily for four weeks or until clinical clearing.

Clotrimazole cream

  • Clotrimazole cream, lotion, or solution is applied to the affected and surrounding skin areas, generally twice daily in the morning and evening.
  • The vaginal cream is inserted via applicator once daily, preferably at night, for 7 consecutive days.
  • The 100 mg vaginal suppository is inserted once daily, preferably at bedtime, for 7 consecutive days.
  • The 200 mg vaginal suppository is inserted once daily for 3 days, preferably at bedtime.


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Are ketoconazole cream and clotrimazole cream safe to use while pregnant or breastfeeding?

Ketoconazole cream

  • This medication should be used only if clearly needed during pregnancy. Discuss the risks and benefits with your doctor.
  • It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.

Clotrimazole cream

  • Clotrimazole cream is very poorly absorbed into the blood and the body after application to the skin or the vagina. Studies in women in their second or third trimesters of pregnancy have demonstrated no ill effects. No data is available in pregnant women during their first trimester. Rats given large amounts of clotrimazole via the vagina have demonstrated no ill effects. 
  • It is not known if clotrimazole is secreted in breast milk.

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