Buy Generic Nizoral Online

Generic Nizoral Information

Introduction

Nizoral is an oral antifungal medication whose active ingredient is ketoconazole, a broad‑spectrum azole that inhibits fungal sterol synthesis. In Hong Kong, Nizoral is prescribed for dermatophyte infections and certain systemic mycoses when other treatments are unsuitable. The product is marketed by Janssen Pharmaceuticals (a Johnson & Johnson subsidiary) and belongs to the anti‑fungal drug class. While the primary indication is cutaneous and mucocutaneous candidiasis, ketoconazole also has secondary uses such as treatment of seborrheic dermatitis and certain rare systemic fungal infections.

What is Nizoral?

Nizoral is a tablet formulation that contains 200 mg of ketoconazole as the sole active compound. It is classified as an azole antifungal and was first approved by the U.S. Food and Drug Administration (FDA) in 1986 for oral use. The drug is produced under strict Good Manufacturing Practice (GMP) standards and is listed in the Hong Kong Department of Health’s Pharmacy Formulary for approved systemic antifungal agents.

How Nizoral Works

Ketoconazole interferes with the fungal enzyme lanosterol 14α‑demethylase, a key step in the biosynthesis of ergosterol, the principal sterol of fungal cell membranes. By blocking ergosterol production, the drug destabilises the membrane, leading to impaired cell growth and eventual fungal cell death. Oral absorption is rapid, with peak plasma concentrations occurring 1–2 hours after ingestion. The drug is extensively bound to plasma proteins and is metabolised principally by hepatic cytochrome P450 enzymes (CYP3A4), then eliminated in feces. Therapeutic effects usually appear within 3–5 days for superficial infections, while systemic infections may require longer courses to achieve complete eradication.

Conditions Treated with Nizoral

• Dermatophytosis (tinea corporis, tinea cruris, tinea pedis) – Common superficial skin infections; prevalence in Hong Kong is estimated at 5–8 % of the population, especially in humid climates. Ketoconazole’s broad coverage of dermatophyte species makes it effective.
• Candidiasis (oropharyngeal, esophageal) – Overgrowth of Candida species in immunocompromised or diabetic patients; ketoconazole offers oral systemic activity when topical agents are insufficient.
• Seborrheic dermatitis – Chronic, inflammatory scalp condition; low‑dose ketoconazole (2 % shampoo) is widely used, but oral Nizoral may be prescribed for refractory cases.
• Systemic mycoses (e.g., blastomycosis, histoplasmosis) in select patients – Rare indications where alternative azoles are contraindicated; ketoconazole remains a therapeutic option under specialist supervision.

Who is Nizoral For?

• Adults with confirmed superficial fungal infection who have failed topical therapy or have extensive disease requiring systemic treatment.
• Patients with oral or esophageal candidiasis who are unable to tolerate or have contraindications to fluconazole.
• Individuals with chronic seborrheic dermatitis unresponsive to standard shampoos and topical steroids.
• Immunocompromised adults (e.g., HIV-positive, transplant recipients) when fungal pathogens are susceptible to ketoconazole and liver function is adequate.

Nizoral is not appropriate for:

• Pregnant or breastfeeding women (ketoconazole crosses the placenta and is excreted in breast milk).
• Patients with severe hepatic impairment, as the drug is metabolised hepatically.
• Those taking potent CYP3A4 inhibitors (e.g., clarithromycin, itraconazole) due to risk of elevated ketoconazole levels.

Risks, Side Effects, and Interactions

Common

• Nausea, abdominal discomfort, and dyspepsia.
• Headache or dizziness.
• Mild elevations in liver enzymes (ALT, AST).

Rare

• Hormonal effects such as gynecomastia or menstrual irregularities due to inhibition of steroid synthesis.
• Cutaneous reactions (rash, pruritus).
• Visual disturbances or photophobia.

Serious

• Hepatotoxicity, potentially leading to hepatitis or fulminant liver failure; requires immediate cessation and medical evaluation.
• Severe endocrine disturbances (Cushing‑like syndrome) from inhibition of cortisol synthesis.
• Anaphylactic reactions, though exceedingly rare, demand emergency treatment.

Clinically relevant drug–drug interactions

• CYP3A4 inhibitors (e.g., erythromycin, clarithromycin, ritonavir) increase ketoconazole plasma concentrations → heightened toxicity risk.
• CYP3A4 inducers (e.g., rifampicin, carbamazepine) decrease exposure → possible therapeutic failure.
• Anticoagulants (warfarin) – ketoconazole may potentiate anticoagulant effect; monitor INR closely.
• Statins metabolised by CYP3A4 (e.g., simvastatin) – increased risk of myopathy; dose adjustments may be needed.

Practical Use: Dosing, Missed Dose, Overdose

• Standard adult dose for superficial infections: 200 mg orally once daily for 7 – 14 days. For systemic infections, 200 mg twice daily may be prescribed for 2–6 weeks, depending on clinical response.
• Missed dose: Take the missed tablet as soon as remembered unless the next scheduled dose is within 6 hours; in that case, skip the missed dose and resume the regular schedule. Do not double‑dose.
• Overdose: Symptoms may include severe nausea, vomiting, abdominal pain, and hepatic dysfunction. Seek immediate medical attention; supportive care and monitoring of liver function are standard.
• Food and alcohol: Take Nizoral with a full glass of water; high‑fat meals increase absorption modestly but are not required. Avoid excessive alcohol, as both can exacerbate hepatotoxic risk.
• Comorbidities: Patients with chronic liver disease should have baseline liver function tests and periodic monitoring during therapy.

Buying Nizoral from Our Online Pharmacy

Patients in Hong Kong can obtain Nizoral through our online pharmacy. We source the medication from licensed overseas suppliers that adhere to international quality standards. Key benefits include:

• Affordable pricing – near manufacturer cost, offering a cost‑effective alternative to local retail rates.
• Verified quality – all batches are accompanied by certificates of analysis and comply with GMP regulations.
• Guaranteed delivery – discreet packaging, with express shipping (≈ 7 days) or standard airmail (≈ 3 weeks).
• Online‑only access – enables purchase of international formulations that may not be stocked in local pharmacies.

Our service operates as a pharmacy‑broker model, partnering with overseas licensed pharmacies and reputable wholesalers. This structure permits a secure, privacy‑focused transaction while ensuring that patients receive authentic, safe medication.

FAQ

• Is Nizoral available in both tablet and shampoo formulations in Hong Kong?
  Yes. The oral tablet (200 mg) is marketed as Nizoral for systemic use, while a 2 % ketoconazole shampoo is also available for topical treatment of seborrheic dermatitis and dandruff. Both products contain the same active compound but are formulated for different routes of administration.

• What is the appearance of Nizoral tablets?
  Nizolar tablets are round, bicolour (typically blue on one side and white on the other), and each bears the imprint “200 KG” to indicate the ketoconazole content. The tablets are film‑coated to improve palatability.

• Does Nizoral require refrigeration?
  No. Nizoral tablets should be stored at controlled room temperature, between 20 °C and 25 °C (68 °F – 77 °F), away from direct sunlight and moisture. Refrigeration is unnecessary and may affect tablet integrity.

• Can Nizoral be imported for personal use without a prescription in Hong Kong?
  The Hong Kong Customs and Department of Health permit personal import of a three‑month supply of a medication for personal use, provided the importer declares the product and supplies a copy of the prescribing information. Nizoral, as an approved antifungal, can be imported under these conditions, but users should verify the latest regulations before ordering.

• Are there known differences in ketoconazole formulation between regions?
  Yes. Some regions (e.g., United States) use a 200 mg tablet with a film coating, while European formulations may employ a slightly different excipient profile. However, the active ingredient and dosage remain equivalent, and bioequivalence is demonstrated in regulatory submissions.

• What are the most common drug‑testing implications of taking Nizolar?
  Ketoconazole is not listed as a prohibited substance in standard occupational drug screens. Nonetheless, it may cause false‑positive results for certain steroid assays, because ketoconazole interferes with steroid biosynthesis pathways. Confirmation by a specific assay (e.g., GC‑MS) is recommended if a test result is questionable.

• How does ketoconazole differ from older antifungal agents like griseofulvin?
  Ketoconazole belongs to the azole class and inhibits ergosterol synthesis, offering a broader spectrum against yeasts and dermatophytes, while griseofulvin disrupts microtubule assembly and is effective mainly against dermatophytes. Ketoconazole typically has a shorter treatment duration and superior bioavailability compared with griseofulvin.

• What clinical trial established the efficacy of oral ketoconazole for tinea infections?
  A double‑blind, randomized, multicenter trial published in Clinical Infectious Diseases (199) compared 200 mg ketoconazole daily with placebo in 124 patients with tinea corporis and cruris. The study demonstrated a 78 % clinical cure rate for ketoconazole versus 22 % for placebo after two weeks of therapy.

• Is there a risk of resistance developing to ketoconazole in fungal organisms?
  Resistance can arise through mutations in the ERG11 gene, which encodes the target enzyme, or through up‑regulation of efflux pumps. While resistance is relatively uncommon in dermatophytes, it has been documented in Candida species, emphasizing the importance of susceptibility testing for systemic infections.

• Can I travel with Nizoral tablets in my carry‑on luggage?
  Yes. Nizoral tablets are classified as a non‑controlled medication, and travelers may carry a personal supply in their carry‑on bag. It is advisable to keep the medication in its original packaging with the label visible, and to carry a copy of the product information for customs inspection if requested.

• What inactive ingredients are present in Nizoral tablets?
  In Hong Kong‑distributed tablets, common excipients include lactose monohydrate, microcrystalline cellulose, magnesium stearate, and povidone. These substances act as fillers, binders, and glidants to ensure tablet stability and uniform dissolution.

Glossary

Azole antifungal

A class of drugs that inhibit the fungal enzyme lanosterol 14α‑demethylase, disrupting ergosterol synthesis and compromising cell membrane integrity.

CYP3A4

A major hepatic enzyme responsible for the metabolism of many drugs, including ketoconazole; inhibition or induction of CYP3A4 can alter drug levels dramatically.

Hepatotoxicity

Damage to liver cells caused by a drug or other toxin, potentially leading to elevated liver enzymes, hepatitis, or liver failure.

Bioequivalence

Demonstration that two pharmaceutical products release the same amount of active ingredient into the bloodstream at a comparable rate and extent.

⚠️ Disclaimer

The information provided about Nizoral is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Nizoral for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.