Psycho-Babble Medication Thread 15094

Shown: posts 1 to 11 of 11. This is the beginning of the thread.

 

paxil and *topical* ketoconazole

Posted by Louisa on November 12, 1999, at 16:26:47

I know that ketoconazole is a big bad no-no with SSRIs, increasing their concentration and all that. But what about *topical* ketoconazole, as in dandruff shampoo (2%)? The damned stuff is the only thing that keeps my scalp from itching madly all day long, and doesn't dry out my hair... My pdoc said she didn't THINK it was a problem, but couldn't give me a completely positive answer. Anyone here know? or if not, can someone recommend a decent dandruff shampoo that doesn't dry out hair?

Thanks!

Louisa

 

Re: paxil and *topical* ketoconazole

Posted by Racer on November 14, 1999, at 23:23:37

In reply to paxil and *topical* ketoconazole, posted by Louisa on November 12, 1999, at 16:26:47

I don't know anything at all about any of this, but I do know that I've used Nizoral shampoo for years, even when I was on Paxil, and now while I'm on Prozac and Effexor I'm still using it...

 

Re: paxil and *topical* ketoconazole

Posted by Adam on November 15, 1999, at 10:48:43

In reply to Re: paxil and *topical* ketoconazole, posted by Racer on November 14, 1999, at 23:23:37

I had to use a 2% keoconazole shampoo for a short time while taking Zoloft, and it was fine. Very little
of the drug is absorbed, even when using 2% ketoconazole cream on large areas (said a board-certified dermatologist
I used to work with long ago). If one were really concerned, I suppose they might try to switch to Celexa, which
isn't metabolized by cytochrome p450, but I really don't think there would be any need.

> I don't know anything at all about any of this, but I do know that I've used Nizoral shampoo for years, even when I was on Paxil, and now while I'm on Prozac and Effexor I'm still using it...

 

thanks

Posted by Louisa on November 15, 1999, at 11:42:27

In reply to Re: paxil and *topical* ketoconazole, posted by Adam on November 15, 1999, at 10:48:43

Thank you both very much for your answer! I've been asking everyone I can think of (pdocs, etc., etc.) and no one had an answer for me. I'll continue using my Nizoral -- goodbye itchy scalp!

Louisa

 

What the h* are *topical* ketoconazoles

Posted by dj on November 15, 1999, at 11:58:00

In reply to paxil and *topical* ketoconazole, posted by Louisa on November 12, 1999, at 16:26:47

It seems at times you need a chemistry degree or at least a pharmacuetical dictionary to try to make heads or tales out of the discussion on many of these threads. As I have neither and have never, ever heard the term ketoconazole
(and probably couldn't pronouce it either like many of these bizarre chemical names) I am very curious what it is, where it is found and what sort of negative interactions it might have with SSRI's -- Prozac for instance. And what about Wellbutrin?

Thanks in advance for the explanation from whoever is goiing to supply it. BTW, maybe this site should be called Better Living (??) Chemically ; )

> I know that ketoconazole is a big bad no-no with SSRIs, increasing their concentration and >all that.

 

Re: What the h* are *topical* ketoconazoles

Posted by dove on November 15, 1999, at 12:04:49

In reply to What the h* are *topical* ketoconazoles, posted by dj on November 15, 1999, at 11:58:00

DJ! You actually made me laugh for the first time in over a week, Yeah!! I think the subject has to do with dandruff and scalps and topical solutions placed onto the head to combat the aforementioned.

dove

 

Re: What the h* are *topical* ketoconazoles

Posted by Adam on November 15, 1999, at 12:24:48

In reply to Re: What the h* are *topical* ketoconazoles, posted by dove on November 15, 1999, at 12:04:49

Ketoconazole is used primarily as an antifungal agent, and can be administered orally
or topically (in a shampoo or a cream). It is a potent inhibitor of many members of the
cytochrome P450 family of enzymes, which are involved in the metabolism of a wide variety
of drugs, largely in but not limited to the liver. Oral ketoconazole can cause problems
if used in combination with other drugs. Topical ketoconazole isn't a problem.

> DJ! You actually made me laugh for the first time in over a week, Yeah!! I think the subject has to do with dandruff and scalps and topical solutions placed onto the head to combat the aforementioned.
>
> dove

 

Re: Please read, many apologies...

Posted by Adam on November 15, 1999, at 12:40:45

In reply to Re: What the h* are *topical* ketoconazoles, posted by Adam on November 15, 1999, at 12:24:48

Actually, I was completely wrong about citalopram and cytochrome P450. It is
metabolized by members of this family, and ketoconazole can indeed interfere
with this. Citalopram is itself thought to inhibit CPs less than some other
SSRIs (and thus be a better choice for the elderly, who often are taking lots
of other medications), but my impression that it was not a concern was totally
mistaken.

> Ketoconazole is used primarily as an antifungal agent, and can be administered orally
> or topically (in a shampoo or a cream). It is a potent inhibitor of many members of the
> cytochrome P450 family of enzymes, which are involved in the metabolism of a wide variety
> of drugs, largely in but not limited to the liver. Oral ketoconazole can cause problems
> if used in combination with other drugs. Topical ketoconazole isn't a problem.
>
> > DJ! You actually made me laugh for the first time in over a week, Yeah!! I think the subject has to do with dandruff and scalps and topical solutions placed onto the head to combat the aforementioned.
> >
> > dove

 

Laughter is the best medicine...

Posted by dj on November 16, 1999, at 1:18:21

In reply to Re: What the h* are *topical* ketoconazoles, posted by dove on November 15, 1999, at 12:04:49

or so says Readers Digest...glad to be of service Dove & if I can think of any otherways to help tickle your funnybone, I'll put them to use...sleep first, though...

 

another big D -- Dandruff

Posted by Louisa on November 16, 1999, at 10:05:33

In reply to Laughter is the best medicine..., posted by dj on November 16, 1999, at 1:18:21

Never thought my dandruff would make anyone laugh... But glad to be of service!

The whole thing did indeed have to do with the possible interactions between my new anti-depressant and my old dandruff shampoo (Nizoral -- 2% ketoconazole). I certainly don't have degrees in any of the above either, and all I could figure out from all the drug interaction charts is that ketoconazole was potentially a problem... but did it matter that I was merely shampooing with it, rather than ingesting it? And thanks to you, I know that depression doesn't have to mean that I have an eternally itchy head!

Louisa

 

Re: another big D -- Dandruff

Posted by dove on November 16, 1999, at 10:41:33

In reply to another big D -- Dandruff, posted by Louisa on November 16, 1999, at 10:05:33

Hi Louisa,
I was in no way laughing at your question, which was a legit concern. I was laughing at DJ's extreme concern over this unfamiliar topical "ketoconazoles". I read all the posts with interest but when I hit DJ's, I couldn't stop myself from laughing, I relate to the feeling of needing a chemistry degree to understand all the interactions and methods of action caused by the various meds.

My best to you and just wanted to let you know that I wasn't taking your questions lightly, as I was interested in the answers myself. Take care :-)

dove


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