What is the Difference Between Fluconazole and Ketoconazole?

Fluconazole and ketoconazole are both antifungal medications used to treat various fungal infections. Here are the key differences between the two:

1. Effectiveness: Fluconazole has a broader range of effectiveness, with a success rate of 74-100% in treating fungal infections, while ketoconazole has a success rate of 42-97%.
2. Toxicity: Ketoconazole is more toxic than fluconazole. It has the potential to increase hepatic enzyme levels during therapy and has caused hepatotoxicity in an estimated 0.1-1.0% of treated patients.
3. Trade Names: The trade names for fluconazole and ketoconazole are Diflucan and Nizoral, respectively.
4. Cerebrospinal Fluid Penetration: Fluconazole is able to penetrate the cerebrospinal fluid, while ketoconazole cannot.

In a study comparing the effectiveness of fluconazole and ketoconazole in the treatment of pityriasis versicolor, fluconazole showed a slightly higher improvement rate after one month of treatment than ketoconazole (81.5% vs. 87.9%, respectively). Due to the hepatotoxicity of ketoconazole, fluconazole may be more suitable for treating extensive pityriasis versicolor. However, another study found that fluconazole and ketoconazole had comparable efficacy and safety in the treatment of oropharyngeal candidiasis in HIV-infected children.

Comparative Table: Fluconazole vs Ketoconazole

Here is a table comparing the differences between fluconazole and ketoconazole:

Fluconazole and ketoconazole are both antifungal medications used to treat various fungal infections. Fluconazole has a higher bioavailability and protein binding ability compared to ketoconazole. The effectiveness of fluconazole is generally higher than that of ketoconazole. However, due to the hepatotoxicity of ketoconazole, fluconazole may be more suitable for treating extensive pityriasis versicolor.