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Ketoconazole vs. Selenium Sulfide: Side Effects & Uses for Dandruff Shampoo

Ketoconazole vs. Selenium Sulfide

What are ketoconazole and selenium sulfide?

Ketoconazole is an anti-fungal medication in the same family of drugs as fluconazole (Diflucan), itraconazole (Sporanox), and miconazole (Micatin, Monistat). It prevents growth of several types of fungi by preventing production of the membranes that surround fungal cells. It is an anti-fungal medication prescribed to treat fungal infections such as thrush, ringworm, jock itch, athlete's foot, dandruff, tinea versicolor, blastomycosis, histoplasmosis, and coccidiomycosis.

Selenium sulfide is a chemical agent commonly used for treating dandruff. It is an antifungal agent that also relieves itching, flaking, scaling, and dry skin on the scalp due to dandruff. Selenium sulfide is also used for treating seborrhea and tinea versicolor, a fungal infection of the skin.

What are the side effects of ketoconazole and selenium sulfide?


Ketoconazole generally is well tolerated. Commonly reported side effects of ketoconazole are:

Other important side effects of ketoconazole are rare; they include:

  • serious allergic reactions (anaphylaxis),
  • severe depression,
  • hair loss, and
  • tingling sensations.

Liver dysfunction also has been reported. Signs of liver problems include unusual fatigue, loss of appetite, nausea and vomiting, yellowing of the skin (jaundice), dark urine, and pale stools. Development of these symptoms while taking ketoconazole should be reported to a physician.

Selenium Sulfide

The common side effects of selenium sulfide are:

  • Oily hair
  • Dry hair
  • Dry scalp
  • Hair loss
  • Hair discoloration

Other side effects of selenium sulfide include:

  • Scalp irritation
  • Skin irritation
  • Tingling
  • Sweating
  • Burning
  • Garlic breath
  • Tremor

What is the dosage of ketonazole vs. selenium sulfide?


Ketoconazole may be taken with or without food. The oral dose range is 200-400 mg daily. Recurrent tinea versicolor is treated with 400 mg monthly. Topical formulations are administered to affected areas once or twice daily.

Selenium Sulfide

For treating dandruff, 5-10 mL of shampoo or lotion should be massaged into wet scalp 2 times per week for 2 weeks then once every 1-2 weeks to control dandruff. The shampoo or lotion should be left on the scalp for 2 to 3 minutes, then rinsed off3 or 4 times with water. The application should be repeated.

Tinea versicolor should be treated by applying lotion or shampoo to the affected area, leaving it on the skin for 10 minutes and then washing it off with water. It should be applied every day for 7 days. The foam should be rubbed into the affected skin every 12 hours.

What drugs interact with ketonazole and selenium sulfide?


There are no drug interactions listed for topical ketonazole.

Selenium Sulfide

There are no drug interactions listed for topical selenium sulfide.

Are ketoconazole and selenium sulfide safe to use while pregnant or breastfeeding?


A small amount of ketoconazole is secreted in breast milk. Nursing mothers should probably avoid breastfeeding while using ketoconazole.

Selenium Sulfide

Use of selenium sulfide during pregnancy has not been adequately evaluated. It is not known whether selenium sulfide is excreted in breast milk.


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