Nizol 200mg
Available Dosages
| SKU | 565 |
|---|---|
| Generic For | Nizoral |
| Strength | 200 mg |
| Manufacturer | Intas |
| Active Ingredient | Ketoconazole |
| Pack Size | Qty | Price Per Pill or Unit | Price | Cart | |
|---|---|---|---|---|---|
| 30 Tablet/s | US$ 1.21 | US$ 36.31 | |||
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| 60 Tablet/s | US$ 1.21 | US$ 72.62 | |||
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| 90 Tablet/s | US$ 1.21 | US$ 108.92 | |||
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Nizol 200mg – Affordable Nizoral Alternative for Fungal Infections
Nizral is a medication comprises of Ketoconazole, which is a synthetic antifungal for oral administration. It is formulated for treating fungal infections that affect the mouth, throat, and skin. The medicine acts by killing certain types of fungi and yeast that are responsible for causing infection, preventing the infection from spreading. It helps relieves infection associated symptoms including, itching and inflammation.
What is Nizral used for?
Nizoral is a medicine available in the form of tablets for oral administration. It is useful in treating fungal infections of the skin, mucous membrane, and skin that cannot be treated with the use of a topical form of medication directly to the affected area. The anti-fungal agent is also helpful in treating persistent fungal infections of the vagina. In addition, it affects treats fungal infections of the throat, stomach, intestines, mouth, or other internal organs. Your health care specialist may also prescribe this antifungal medication for another reason. Therefore, it is necessary to consult with your health care specialist before starting the treatment with Nizral tablets.
How does Nizral work?
The active component of the medicine is Ketoconazole, which falls into the category of drugs known as antifungals. This antifungal agent works to stop the growth and fungus.
What does Nizral contain?
Nizral tables contain Ketoconazole as an active ingredient. Each tablet delivers 200 mg of the beneficial ingredient.
What medications interact with Nizral?
You should tell your health care specialist about all the medicines that you are recently taking or have recently taken. These medication sinclude vitamin, herbal supplements, or non prescription medicines.
- Cholesterol lowering medicine such as simvastatin and lovastatin
- Cisapride for digestive system disorders
- Eplerenone fro heart failure
- Anticancer drug like irinotecan
- Midazolam or triazolam to help you sleep
- Astemizole, mizolastine, terfenadine for allergy and hayfever
- Eplerenone to treat heart failure
- Halofantrine, a medicine useful in treating malaria
- Everolimus, a medicine given after an organ transplant
- Pimozide or sertindole for conditions that affects thoughts, behavior, and feeling
- Levacetylmethadol, a medicine useful in treating severe pain or for managing addiction
- Medications like methylergometrine or ergometrine given after childbirth
- Ergotamine to treat a migraine
Do not start taking Nizrol tablets and inform your health care specialist if you are taking any of the above medications.
When should Nizral not be used?
- The medicine should not be used if you are allergic to any ingredients of the medication.
- Do not use it if you are suffering hepatic insufficiency
Effects of alcohol on Nizral
Consuming alcohol while taking Nizral tablets may cause serious adverse effects such as a rash, headache, or make you feel sick. People taking Nizral tablets are advised not to drink alcohol while taking this antifungal agent. You must talk to your health care specialist if you are an alcoholic or have been treated for alcoholism. Your health care specialist will decide if can take this antifungal tablets.
What are the side effects of Nizral?
Some common side effects of Nizral that you may experience with the usage of Nizral tablets are given below:
- Itching
- Stomach pain
- Feeling sick or being sick
How should Nizral be taken?
People are instructed to take Nizral tablets exactly as your health care specialist has told you to. You should check with your health care specialist if you have any doubt about the usage of medicine.
Prefer taking the Nizral tablet with food as this help your body to use the medicine. Swallow the tablet with a glass full of water. It is important that you have enough acid in your stomach to make sure that your body can use this antifungal agent. Medicines used for treating problems like stomach ulcers, heartburn, or indigestion can affect the acid present in your stomach. People are advised to wait for atleast two hours after taking Nizral tablets before consuming any of these other medications.
The dose of the medicine depends on the type of infection, type of fungus, or body weight of your child. Your health care specialist will tell you how many tablets you require to take your fungal infection.
How long should you take Nizral?
Depending on your condition, your health care specialist will tell you for how long you need to take Nizral tablets.
Missed dose of Nizral
If you forget to take a dose of Nizral tablet, take it when you remember. Then keep on taking the tablet as your health care specialist has told you. Always remember, do not take double doses to make up for the missed doses.
How should Nizral be stored?
- Ensure that your children and pets don't have access to the medication.
- Store it at controlled room temperature
- Keep the tablets in its original package
What is Nizol 200mg used for?
Nizol 200mg contains ketoconazole 200mg — an oral imidazole antifungal. Due to significant hepatotoxicity risk, oral ketoconazole is rarely used as a systemic antifungal today — it has been largely replaced by safer triazoles (fluconazole, itraconazole). However, ketoconazole 200mg is used as a second-line option for: endemic mycoses (histoplasmosis, blastomycosis, paracoccidioidomycosis — when itraconazole/fluconazole are unavailable); chronic mucocutaneous candidiasis; onychomycosis as a last resort; and in oncology — prostate cancer treatment (ketoconazole inhibits adrenal and testicular androgen synthesis at 400mg TID).
How does Nizol 200mg work and why is its use limited?
Oral ketoconazole inhibits ergosterol synthesis via CYP51 (lanosterol demethylase) in fungi — the same mechanism as triazoles. It also inhibits human steroidogenesis (cortisol, testosterone synthesis) — the basis for its oncological use. Oral ketoconazole's use is limited by: (1) significant hepatotoxicity risk — liver failure in approximately 1 in 10,000–15,000 patients; (2) potent CYP3A4/CYP2C9 inhibitor — extensive drug interactions; (3) poor absorption in achlorhydric states (needs gastric acid); (4) adrenal suppression at high doses. Regulatory agencies (FDA, EMA) have issued warnings restricting oral ketoconazole to situations where other antifungals cannot be used.
What monitoring is mandatory with Nizol 200mg therapy?
LFT monitoring is mandatory and non-negotiable: baseline before starting; at 2 weeks; at 4 weeks; then monthly. Stop ketoconazole immediately if ALT/AST >2× upper limit of normal or if any symptoms of hepatitis appear (jaundice, fatigue, anorexia, dark urine). Also monitor: cortisol levels if symptoms of adrenal insufficiency (fatigue, low , nausea — especially with higher doses); QT interval on ECG (ketoconazole prolongs QT); drug interactions (comprehensive review of all co-medications is essential). The monitoring burden reflects the seriousness of ketoconazole's hepatotoxicity risk — this is why safer azoles have replaced it for most indications.
What drug interactions make Nizol 200mg particularly problematic?
Oral ketoconazole is one of the most potent CYP3A4 inhibitors available — interactions are extensive and clinically severe. Absolutely contraindicated combinations: pimozide (fatal arrhythmias), quinidine, disopyramide, dofetilide, dronedarone (QT prolongation/arrhythmias), cisapride (arrhythmias), simvastatin/lovastatin (rhabdomyolysis), oral triazolam/alprazolam (excessive sedation), ergot alkaloids (ergotism). Significantly elevated levels: ciclosporin, tacrolimus (renal toxicity), warfarin, phenytoin, indinavir, saquinavir. Drugs reducing ketoconazole absorption: antacids, PPIs, H2 antagonists (need gastric acid for absorption — take ketoconazole with acidic drink if on acid-reducing therapy).
How does Nizol 200mg compare to itraconazole for fungal infections?
Both ketoconazole and itraconazole are imidazoles/triazoles with similar antifungal spectra. Itraconazole is strongly preferred over ketoconazole: significantly lower hepatotoxicity risk, similar drug interaction profile but with itraconazole being better studied and managed in clinical practice, and superior activity against Aspergillus (which ketoconazole lacks). Itraconazole has replaced ketoconazole for virtually all its antifungal indications including endemic mycoses, onychomycosis, and mucocutaneous candidiasis. Ketoconazole 200mg should only be used when itraconazole and other safe antifungals are genuinely unavailable or contraindicated — not as a routine alternative.
Is Nizol 200mg equivalent to Nizoral 200mg?
Yes. Nizol 200mg and branded Nizoral 200mg tablets both contain ketoconazole 200mg in bioequivalent formulations. Nizol is the generic alternative. Given ketoconazole's significant safety concerns, ensuring genuine, quality-controlled product from a licensed pharmacy is particularly important — substitution with poorly manufactured generics could alter bioavailability and either reduce efficacy or worsen toxicity risk.
Can I order Nizol 200mg from PremiumRxDrugs for international delivery?
Yes. PremiumRxDrugs.com ships Nizol 200mg to the USA, UK, Australia, and many other countries. Our genuine manufacturer-verified medications, competitive pricing, and free worldwide shipping on qualifying orders make us a reliable international pharmacy for specialist-prescribed ketoconazole therapy.
What side effects does Nizol 200mg cause?
Common: nausea and vomiting (take with food), abdominal discomfort, and headache. Hepatotoxicity: the primary safety concern (see monitoring section) — jaundice, hepatitis, fulminant hepatic failure. Adrenal suppression: fatigue, dizziness, low blood pressure — particularly at doses ≥400mg/day. Gynaecomastia (breast enlargement in men) from testosterone synthesis inhibition. Menstrual irregularities in women from sex hormone effects. QT prolongation. Anaphylaxis (rare). Rash. Due to the severity of potential hepatotoxicity, patients must be clearly informed to seek immediate medical attention if they develop any symptoms suggesting liver problems.
When is oral Nizol 200mg still appropriate despite its risks?
Oral ketoconazole 200mg remains appropriate in specific limited circumstances: (1) resource-limited settings where itraconazole and fluconazole are genuinely unavailable for endemic mycoses treatment; (2) prostate cancer — ketoconazole 400mg TID (with hydrocortisone replacement) provides androgen synthesis inhibition as second-line hormonal therapy in castration-resistant prostate cancer; (3) refractory or unusual fungal infections unresponsive to safer agents under expert guidance; (4) research settings. Outside these specific situations, current regulatory guidance from the FDA and EMA recommends against using oral ketoconazole for fungal infections when safer alternatives exist — the hepatotoxicity risk outweighs potential benefits in routine practice.
Does Nizol 200mg require gastric acid for absorption?
Yes — ketoconazole absorption depends on gastric acid for dissolution. Patients on proton pump inhibitors (omeprazole, lansoprazole), H2 receptor antagonists (ranitidine, famotidine), or antacids have markedly reduced ketoconazole absorption — potentially subtherapeutic drug levels. If these agents cannot be avoided, administer ketoconazole with an acidic beverage (cola, acidic orange juice, dilute hydrochloric acid solution) to compensate. Separate antacid administration by at least 2 hours from ketoconazole. This acid-dependence is a significant practical limitation compared to itraconazole cyclodextrin solution (more reliable acid-independent absorption) and fluconazole (excellent absorption regardless of gastric pH).
What precautions apply to Nizol 200mg regarding adrenal suppression?
Oral ketoconazole inhibits adrenal cortisol and aldosterone synthesis in a dose-dependent manner. At therapeutic antifungal doses (200–400mg/day), adrenal suppression is usually subclinical but may become clinically significant during illness or surgery — monitor for symptoms of adrenal insufficiency (fatigue, nausea, low blood pressure, dizziness). At higher doses (400mg three times daily for prostate cancer), significant adrenal suppression occurs intentionally — hydrocortisone replacement (20–40mg/day) is co-prescribed to prevent adrenal crisis. Patients on any ketoconazole dose should carry a steroid emergency card if prolonged treatment is planned, especially before any surgical procedure or serious illness.
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