{"id":53706,"date":"2023-09-20T09:49:35","date_gmt":"2023-09-20T09:49:35","guid":{"rendered":"https:\/\/medsname.com\/ketocip\/"},"modified":"2026-04-30T10:25:10","modified_gmt":"2026-04-30T10:25:10","slug":"ketocip","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/ketocip\/","title":{"rendered":"Ketocip"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 20px;margin:18px 0;border-radius:6px;\">\n<h3 style=\"margin-top:0;\">\ud83d\udca1 Rychl\u00e1 odpov\u011b\u010f<\/h3>\n<p style=\"margin-bottom:0;\">Ketocip je ketokonazol 200 mg peror\u00e1ln\u00ed tableta \u2014 star\u0161\u00ed imidazolov\u00e9 antimykotikum. <strong>FDA, EMA, MHRA, Health Canada v\u0161echny omezily peror\u00e1ln\u00ed ketokonazol kv\u016fli z\u00e1va\u017en\u00e9 hepatotoxicit\u011b, adren\u00e1ln\u00ed insuficienci a riziku l\u00e9kov\u00fdch interakc\u00ed.<\/strong> NEM\u011aL by b\u00fdt pou\u017e\u00edv\u00e1n jako prvn\u00ed volba u ko\u017en\u00edch, vagin\u00e1ln\u00edch nebo nehtov\u00fdch myk\u00f3z \u2014 flukonazol \/ itrakonazol \/ terbinafin jsou bezpe\u010dn\u011bj\u0161\u00ed. Zb\u00fdvaj\u00edc\u00ed \u00fazk\u00e9 indikace: endemick\u00e9 myk\u00f3zy (blastomyk\u00f3za, parakokcidioidomyk\u00f3za) p\u0159i selh\u00e1n\u00ed alternativ a Cushing\u016fv syndrom (off-label suprese kortizolu). Topick\u00fd ketokonazol (kr\u00e9m, lotion, \u0161ampon) nen\u00ed t\u011bmito varov\u00e1n\u00edmi ovlivn\u011bn.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f5f5f5;border:1px solid #e1e1e1;padding:18px 22px;margin:24px 0;border-radius:8px;display:flex;flex-wrap:wrap;justify-content:space-around;gap:16px;align-items:center;font-size:0.95em;\">\n<div style=\"text-align:center;flex:1;min-width:140px;\">\ud83c\udfed<br \/><strong>WHO-GMP<\/strong><br \/>certifikovan\u00fd v\u00fdrobce<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<div style=\"text-align:center;flex:1;min-width:140px;\">\ud83d\udce6<br \/><strong>Diskr\u00e9tn\u00ed balen\u00ed<\/strong><br \/>oby\u010dejn\u00e1 ob\u00e1lka<\/div>\n<div style=\"text-align:center;flex:1;min-width:140px;\">\ud83c\udf0d<br \/><strong>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/strong><br \/>do v\u011bt\u0161iny zem\u00ed<\/div>\n<div style=\"text-align:center;flex:1;min-width:140px;\">\u2b50<br \/><strong>1 400+ z\u00e1kazn\u00edk\u016f<\/strong><br \/><a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">\u010d\u00edst recenze<\/a><\/div>\n<\/div>\n<h2>\ud83d\udd12 Pro\u010d objedn\u00e1vat Ketocip z MedsBase<\/h2>\n<ul>\n<li><strong>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/strong> \u2014 dod\u00e1v\u00e1no z regulovan\u00e9ho za\u0159\u00edzen\u00ed, kompletn\u00ed balen\u00ed s \u010d\u00edslem \u0161ar\u017ee a datem expirace.<\/li>\n<li><strong>Diskr\u00e9tn\u00ed balen\u00ed<\/strong> \u2014 oby\u010dejn\u00e1 ob\u00e1lka, bez uveden\u00ed n\u00e1zvu l\u00e9ku na vn\u011bj\u0161\u00ed stran\u011b.<\/li>\n<li><strong>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/strong> do v\u011bt\u0161iny zem\u00ed s <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\">Reshipment Assurance<\/a>.<\/li>\n<li><strong>V\u011brnostn\u00ed body<\/strong> \u2014 1 bod za ka\u017ed\u00fd utracen\u00fd 1$ (neplat\u00ed pro peptidy\/dopravu); 100 bod\u016f = 5$ sleva na dal\u0161\u00ed objedn\u00e1vku.<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 20px;margin:20px 0;border-radius:6px;\"><strong>FDA black-box varov\u00e1n\u00ed \u2014 peror\u00e1ln\u00ed ketokonazol<\/strong><\/p>\n<div>\n<p>Po p\u0159ezkumu v roce 2013 regula\u010dn\u00ed org\u00e1ny v\u011bt\u0161inou odebraly licenci peror\u00e1ln\u00edmu ketokonazolu pro b\u011b\u017en\u00e9 mykotick\u00e9 infekce:<\/p>\n<ul>\n<li><strong>Z\u00e1va\u017en\u00e1 hepatotoxicita<\/strong> \u2014 fat\u00e1ln\u00ed selh\u00e1n\u00ed jater se vyskytlo i p\u0159i kr\u00e1tkodob\u00e9m u\u017e\u00edv\u00e1n\u00ed. Riziko je d\u00e1vkov\u011b z\u00e1visl\u00e9 a idiosynkratick\u00e9.<\/li>\n<li><strong>Adren\u00e1ln\u00ed insuficience<\/strong> \u2014 ketokonazol inhibuje adren\u00e1ln\u00ed steroidogenezi ji\u017e v terapeutick\u00fdch d\u00e1vk\u00e1ch (proto se off-label pou\u017e\u00edv\u00e1 u Cushingova syndromu).<\/li>\n<li><strong>QT prolongation and torsades<\/strong> s l\u00e9ky metabolizovan\u00fdmi CYP3A4.<\/li>\n<li><strong>Z\u00e1va\u017en\u00e9 l\u00e9kov\u00e9 interakce<\/strong> v\u00fdraznou inhibic\u00ed CYP3A4.<\/li>\n<\/ul>\n<p><strong>P\u0159i vagin\u00e1ln\u00ed kandid\u00f3ze, orofarynge\u00e1ln\u00ed kandid\u00f3ze, dermatofyt\u00f3ze (tinea) \/ onychomyk\u00f3ze nebo pityriasis versicolor \u2014 pou\u017eijte m\u00edsto toho flukonazol, itrakonazol nebo terbinafin.<\/strong> Topick\u00fd ketokonazol ve form\u011b kr\u00e9mu \/ lotionu \/ \u0161amponu nen\u00ed ovlivn\u011bn \u2014 je \u0161patn\u011b absorbov\u00e1n a z\u016fst\u00e1v\u00e1 vhodnou volbou pro k\u016f\u017ei a poko\u017eku hlavy.<\/p>\n<\/div>\n<\/div>\n<h2 id=\"uses\">Zb\u00fdvaj\u00edc\u00ed \u00fazk\u00e9 indikace<\/h2>\n<p>Ketocip (ketokonazol 200 mg, Cipla) v peror\u00e1ln\u00ed form\u011b se nyn\u00ed pou\u017e\u00edv\u00e1 pouze tehdy, kdy\u017e jin\u00e1 antimykotika nejsou tolerov\u00e1na nebo jsou kontraindikov\u00e1na, nebo v specifick\u00fdch indikac\u00edch, kde z\u016fst\u00e1v\u00e1 l\u00e9\u010dbou s prok\u00e1zanou \u00fa\u010dinnost\u00ed:<\/p>\n<ul>\n<li>Endemick\u00e9 myk\u00f3zy \u2014 blastomyk\u00f3za, parakokcidioidomyk\u00f3za, histoplazm\u00f3za, chromoblastomyk\u00f3za \u2014 kde selhal amfotericin B nebo itrakonazol, nebo nejsou k dispozici.<\/li>\n<li>Cushing\u016fv syndrom \u2014 l\u00e9k druh\u00e9 volby ke sn\u00ed\u017een\u00ed kortizolu (mimo schv\u00e1len\u00e9 indikace, zah\u00e1jeno v nemocnici, pod dohledem).<\/li>\n<li>Odoln\u00e1 pityriasis versicolor, kter\u00e1 nereagovala na topickou a peror\u00e1ln\u00ed l\u00e9\u010dbu flukonazolem \/ itrakonazolem.<\/li>\n<\/ul>\n<h2 id=\"dose\">D\u00e1vkov\u00e1n\u00ed &amp; monitorov\u00e1n\u00ed<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;font-size:0.95em;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">Indikace<\/th>\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">Re\u017eim<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Endemick\u00e9 myk\u00f3zy<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">200\u2013400 mg denn\u011b s j\u00eddlem; d\u00e9lka l\u00e9\u010dby podle doporu\u010den\u00ed specialisty na infek\u010dn\u00ed choroby (\u010dasto 6\u201312 m\u011bs\u00edc\u016f)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Cushing\u016fv syndrom (mimo schv\u00e1len\u00e9 indikace)<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">200 mg dvakr\u00e1t denn\u011b, s mo\u017en\u00fdm zv\u00fd\u0161en\u00edm na 400\u20131200 mg\/den v rozd\u011blen\u00fdch d\u00e1vk\u00e1ch<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Monitorov\u00e1n\u00ed je nezbytn\u00e9:<\/strong><\/p>\n<ul>\n<li>Z\u00e1kladn\u00ed jatern\u00ed testy, pot\u00e9 ka\u017ed\u00e9 2 t\u00fddny po prvn\u00ed 2 m\u011bs\u00edce, pot\u00e9 m\u011bs\u00ed\u010dn\u011b.<\/li>\n<li>Okam\u017eit\u011b ukon\u010dete l\u00e9\u010dbu, pokud AST\/ALT &gt; 3\u00d7 ULN NEBO \u017eloutenka, tmav\u00e1 mo\u010d nebo p\u0159etrv\u00e1vaj\u00edc\u00ed nevolnost.<\/li>\n<li>Z\u00e1kladn\u00ed EKG; opakujte p\u0159i sou\u010dasn\u00e9m p\u0159edepisov\u00e1n\u00ed l\u00e9k\u016f prodlu\u017euj\u00edc\u00edch QT interval.<\/li>\n<li>Pro pou\u017eit\u00ed u Cushingova syndromu: rann\u00ed kortizol, voln\u00fd kortizol v mo\u010di a ACTH stimula\u010dn\u00ed test p\u0159i p\u0159\u00edznac\u00edch nazna\u010duj\u00edc\u00edch adren\u00e1ln\u00ed insuficienci.<\/li>\n<\/ul>\n<h2 id=\"how-to-take\">Jak u\u017e\u00edvat<\/h2>\n<p>U\u017e\u00edvejte s j\u00eddlem \u2013 pro rozpou\u0161t\u011bn\u00ed kapsle a absorpci je nutn\u00e1 \u017ealude\u010dn\u00ed kyselina. Vyhn\u011bte se sou\u010dasn\u00e9mu u\u017e\u00edv\u00e1n\u00ed PPI \/ H2-blok\u00e1tor\u016f \/ antacid, pokud nejsou odd\u011bleny alespo\u0148 2 hodinami.<\/p>\n<h2 id=\"mechanism\">Jak to funguje<\/h2>\n<p>Ketokonazol inhibuje fung\u00e1ln\u00ed CYP51 (lanosterol 14-\u03b1-demethyl\u00e1zu) \u2013 stejn\u00fd c\u00edl jako flukonazol a itrakonazol. Je m\u00e9n\u011b selektivn\u00ed ne\u017e nov\u011bj\u0161\u00ed triazoly, tak\u00e9 inhibuje lidsk\u00e9 steroidogenezn\u00ed enzymy (CYP17, CYP11B1, CYP11B2) \u2013 co\u017e je z\u00e1klad jak pro pou\u017eit\u00ed u Cushingova syndromu, tak pro adren\u00e1ln\u00ed insuficienci jako vedlej\u0161\u00ed \u00fa\u010dinek.<\/p>\n<h2 id=\"side-effects\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;font-size:0.95em;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">Frekvence<\/th>\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">\u00da\u010dinky<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">B\u011b\u017en\u00e9<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Nevolnost, bolesti b\u0159icha, bolest hlavy, z\u00e1vrat\u011b, gynekomastie (u mu\u017e\u016f, z\u00e1visl\u00e9 na d\u00e1vce)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">M\u00e9n\u011b \u010dast\u00e9<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Ztr\u00e1ta libida, oligospermie, fotofobie<\/td>\n<\/tr>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Vz\u00e1cn\u00e9, ale z\u00e1va\u017en\u00e9<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\"><strong>Fat\u00e1ln\u00ed hepatotoxicita<\/strong> (1 z ~10 000 \u2013 idiosynkratick\u00e1, m\u016f\u017ee se objevit b\u011bhem prvn\u00edho m\u011bs\u00edce), adren\u00e1ln\u00ed insuficience, prodlou\u017een\u00ed QT intervalu, anafylaxe, z\u00e1va\u017en\u00e9 ko\u017en\u00ed reakce<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 id=\"interactions\">Interakce l\u00e9k\u016f<\/h2>\n<p>Ketokonazol pat\u0159\u00ed mezi nejsiln\u011bj\u0161\u00ed zn\u00e1m\u00e9 inhibitory CYP3A4 \u2013 zvy\u0161uje hladiny jak\u00e9hokoli l\u00e9ku metabolizovan\u00e9ho CYP3A4. Vybran\u00e9 v\u00fdznamn\u00e9 interakce:<\/p>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;font-size:0.95em;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">L\u00e9k<\/th>\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">\u00da\u010dinek<\/th>\n<th style=\"padding:8px;text-align:left;border:1px solid #ccc;\">\u00da\u010dinek<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Pimozide, terfenadine, astemizole, cisapride, dofetilide, quinidin<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Prodlou\u017een\u00ed QT intervalu \u2192 torsade de pointes<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Kontraindikov\u00e1no<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Triazolam, midazolam, alprazolam (peror\u00e1ln\u00ed)<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">T\u011b\u017ek\u00e1 sedace<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Kontraindikov\u00e1no<\/td>\n<\/tr>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Statiny (simvastatin, atorvastatin, lovastatin)<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Rabdomyol\u00fdza<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Kontraindikov\u00e1no; p\u0159ej\u00edt na pravastatin \/ rosuvastatin<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Alkaloidy n\u00e1melu<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Vazokonstrikce, ergotismus<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Kontraindikov\u00e1no<\/td>\n<\/tr>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Tacrolimus, cyklosporin, sirolimus<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Toxicita<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">V\u00fdrazn\u011b sn\u00ed\u017eit d\u00e1vku; monitorovat hladiny<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Warfarin<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Vzestup INR<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Pe\u010dliv\u011b monitorujte<\/td>\n<\/tr>\n<tr style=\"background:#fff;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Apixaban, rivaroxaban<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Krv\u00e1cen\u00ed<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Vyhnout se<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ccc;\">Metadon<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Prodlou\u017een\u00ed QT intervalu, sedace<\/td>\n<td style=\"padding:8px;border:1px solid #ccc;\">Vyhnout se<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 id=\"contraindications\">Kontraindikace<\/h2>\n<ul>\n<li>Akutn\u00ed nebo chronick\u00e9 jatern\u00ed onemocn\u011bn\u00ed.<\/li>\n<li>Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f prodlu\u017euj\u00edc\u00edch QT interval.<\/li>\n<li>Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed simvastatinu \/ atorvastatinu \/ lovastatinu \/ triazolamu \/ midazolamu (peror\u00e1ln\u00ed) \/ ergotov\u00fdch alkaloid\u016f.<\/li>\n<li>T\u011bhotenstv\u00ed a kojen\u00ed.<\/li>\n<li>P\u0159ecitliv\u011blost na azoly.<\/li>\n<\/ul>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3>Pro\u010d je peror\u00e1ln\u00ed ketokonazol \u2018omezen\u2019?<\/h3>\n<p>FDA, EMA, MHRA a Health Canada v letech 2013\u20132014 dosp\u011bly k z\u00e1v\u011bru, \u017ee fat\u00e1ln\u00ed hepatotoxicita \u010din\u00ed peror\u00e1ln\u00ed ketokonazol nevhodn\u00fdm pro b\u011b\u017en\u00e9 pl\u00eds\u0148ov\u00e9 infekce, pokud existuj\u00ed bezpe\u010dn\u011bj\u0161\u00ed alternativy (flukonazol, itrakonazol, terbinafin). \u0160ampon \/ kr\u00e9m s ketokonazolem pro m\u00edstn\u00ed pou\u017eit\u00ed nen\u00ed ovlivn\u011bn \u2014 jeho syst\u00e9mov\u00e1 absorpce je minim\u00e1ln\u00ed.<\/p>\n<h3>M\u011bl bych tento l\u00e9k u\u017e\u00edvat na atletickou nohu nebo kvasinkovou infekci?<\/h3>\n<p>T\u00e9m\u011b\u0159 jist\u011b ne. Standardn\u00ed l\u00e9\u010dba vagin\u00e1ln\u00ed kandid\u00f3zy je flukonazol 150 mg v jedn\u00e9 d\u00e1vce; u tinea pedis 4t\u00fddenn\u00ed lok\u00e1ln\u00ed antimykotikum nebo peror\u00e1ln\u00ed terbinafin; u or\u00e1ln\u00ed kandid\u00f3zy flukonazol nebo itrakonazol v peror\u00e1ln\u00edm roztoku. Proberte zm\u011bnu l\u00e9\u010dby se sv\u00fdm l\u00e9ka\u0159em.<\/p>\n<h3>Je lok\u00e1ln\u00ed ketokonazol st\u00e1le bezpe\u010dn\u00fd?<\/h3>\n<p>Ano \u2014 \u0161ampon s ketokonazolem (pro seboroickou dermatitidu, lupy) a kr\u00e9m \/ lotio (pro tineu, kandid\u00f3zu, pityriasis versicolor) nejsou t\u011bmito regula\u010dn\u00edmi omezen\u00edmi dot\u010deny. M\u00edstn\u00ed absorpce je minim\u00e1ln\u00ed.<\/p>\n<h3>Jak ketokonazol ovliv\u0148uje m\u00e9 hormony?<\/h3>\n<p>Inhibuje synt\u00e9zu kortizolu v nadledvin\u00e1ch (proto se off-label pou\u017e\u00edv\u00e1 u Cushingova syndromu) a synt\u00e9zu testosteronu ve varlatech. Dlouhodob\u00e1 vysokod\u00e1vkov\u00e1 peror\u00e1ln\u00ed terapie m\u016f\u017ee zp\u016fsobit adren\u00e1ln\u00ed insuficienci, gynekomastii u mu\u017e\u016f, oligospermii, ztr\u00e1tu libida a menstrua\u010dn\u00ed nepravidelnosti u \u017een.<\/p>\n<h3>Jak\u00e9 jsou p\u0159\u00edznaky po\u0161kozen\u00ed jater?<\/h3>\n<p>\u017dloutnut\u00ed k\u016f\u017ee nebo o\u010d\u00ed, tmav\u00e1 mo\u010d, sv\u011btl\u00e1 stolice, p\u0159etrv\u00e1vaj\u00edc\u00ed nevolnost, bolest v prav\u00e9m pod\u017eeb\u0159\u00ed, siln\u00e1 \u00fanava, zmatenost. Okam\u017eit\u011b p\u0159esta\u0148te l\u00e9k u\u017e\u00edvat a vyhledejte l\u00e9ka\u0159skou pomoc. Hepatotoxicita m\u016f\u017ee nastat n\u00e1hle a b\u00fdt fat\u00e1ln\u00ed \u2014 v\u010dasn\u00e9 rozpozn\u00e1n\u00ed je kl\u00ed\u010dov\u00e9.<\/p>\n<h3>Co kdy\u017e jsem ji\u017e dokon\u010dil(a) kr\u00e1tk\u00fd cyklus ketokonazolu?<\/h3>\n<p>Pokud jste dokon\u010dili kr\u00e1tk\u00fd cyklus (nap\u0159. 1\u20132 t\u00fddny u blastomyk\u00f3zy nebo refraktern\u00ed pityriasis versicolor) bez p\u0159\u00edznak\u016f, je nepravd\u011bpodobn\u00e9, \u017ee byste nyn\u00ed m\u011bli opo\u017ed\u011bnou hepatotoxicitu. Pokud m\u00e1te jak\u00e9koli p\u0159\u00edznaky (\u017eloutenka, tmav\u00e1 mo\u010d), vyhledejte l\u00e9ka\u0159skou pomoc. U budouc\u00edch pl\u00eds\u0148ov\u00fdch infekc\u00ed \u2014 proberte bezpe\u010dn\u011bj\u0161\u00ed alternativy.<\/p>\n<h3>Pro\u010d se ketokonazol n\u011bkdy st\u00e1le pou\u017e\u00edv\u00e1 u Cushingova syndromu?<\/h3>\n<p>Proto\u017ee inhibuje synt\u00e9zu kortizolu v nadledvin\u00e1ch. U Cushingova syndromu je to \u017e\u00e1douc\u00ed \u00fa\u010dinek \u2014 sn\u00ed\u017een\u00ed nadbytku. Nutn\u00fd dohled endokrinologa; alternativy zahrnuj\u00ed metyrapon, mifepriston, osilodrostat nebo bilater\u00e1ln\u00ed adrenalektomii.<\/p>\n<h3>M\u016f\u017ee se ketokonazol pou\u017e\u00edvat u rakoviny (nap\u0159. prostaty)?<\/h3>\n<p>Historicky se pou\u017e\u00edval ve vysok\u00fdch d\u00e1vk\u00e1ch (1200 mg\/den) k potla\u010den\u00ed synt\u00e9zy androgen\u016f ve varlatech a nadledvin\u00e1ch u pokro\u010dil\u00e9ho karcinomu prostaty. Dnes je v\u011bt\u0161inou nahrazen abirateronem, enzalutamidem apod. Nen\u00ed prvn\u00ed volbou v onkologick\u00e9 l\u00e9\u010db\u011b.<\/p>\n<h3>Je Ketocip stejn\u00fd jako Nizoral?<\/h3>\n<p>Ano \u2014 Nizoral je p\u016fvodn\u00ed zna\u010dka ketokonazolu od spole\u010dnosti Janssen. Ketocip obsahuje stejnou \u00fa\u010dinnou l\u00e1tku, vyr\u00e1b\u011bnou spole\u010dnost\u00ed Cipla v souladu s normami WHO-GMP. Regula\u010dn\u00ed omezen\u00ed plat\u00ed stejn\u011b pro v\u0161echny zna\u010dky peror\u00e1ln\u00edho ketokonazolu.<\/p>\n<h3>Jak\u00e9 antimykotikum bych m\u011bl m\u00edsto toho u\u017e\u00edvat?<\/h3>\n<p>Z\u00e1vis\u00ed na infekci. Vagin\u00e1ln\u00ed kandid\u00f3za \u2192 flukonazol 150 mg v jedn\u00e9 d\u00e1vce. Or\u00e1ln\u00ed kandid\u00f3za \u2192 flukonazol 100 mg\/den \u00d7 7 dn\u00ed. Tinea pedis\/cruris \u2192 topick\u00fd terbinafinov\u00fd kr\u00e9m \u00d7 1\u20134 t\u00fddny. Onychomyk\u00f3za \u2192 peror\u00e1ln\u00ed terbinafin 250 mg\/den \u00d7 6 t\u00fddn\u016f (nehty na rukou) nebo 12 t\u00fddn\u016f (nehty na nohou). Pityriasis versicolor \u2192 topick\u00fd ketokonazolov\u00fd \u0161ampon nebo peror\u00e1ln\u00ed flukonazol.<\/p>\n<h2 id=\"storage\">Skladov\u00e1n\u00ed<\/h2>\n<p>Tablety skladujte p\u0159i 15\u201325 \u00b0C, mimo dosah vlhkosti a sv\u011btla. Nepou\u017e\u00edvejte po uplynut\u00ed doby pou\u017eitelnosti. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Dal\u0161\u00ed antifung\u00e1ln\u00ed l\u00e9ky, kter\u00e9 by v\u00e1s mohly zaj\u00edmat<\/h2>\n<p>Peror\u00e1ln\u00ed ketokonazol ji\u017e nen\u00ed prvn\u00ed volbou pro b\u011b\u017en\u00e9 pl\u00eds\u0148ov\u00e9 infekce. N\u00ed\u017ee jsou uvedeny doporu\u010den\u00e9 alternativy pro b\u011b\u017en\u00e9 indikace.<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zocon\/\"><strong>Zocon (fluconazol 150 mg)<\/strong><\/a> \u2014 Peror\u00e1ln\u00ed l\u00e9k prvn\u00ed volby pro kandid\u00f3zu \u2014 bezpe\u010dn\u011bj\u0161\u00ed ne\u017e peror\u00e1ln\u00ed ketokonazol.<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zimig\/\"><strong>Zimig (terbinafin 250 mg)<\/strong><\/a> \u2014 Peror\u00e1ln\u00ed l\u00e9k prvn\u00ed volby pro dermatofyt\u00f3zu neht\u016f\/vlasov\u00e9 poko\u017eky\/rozs\u00e1hl\u00e9 ko\u017en\u00ed infekce.<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/sporanox-capsule\/\"><strong>Sporanox (itraconazol 100 mg)<\/strong><\/a> \u2014 Pro nedermatofytn\u00ed pl\u00edsn\u011b, dimorfn\u00ed myk\u00f3zy, sm\u00ed\u0161en\u00e9 kandid\u00f3zy.<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/keto-cream\/\"><strong>Keto Cream (ketokonazol 2%)<\/strong><\/a> \u2014 Lok\u00e1ln\u00ed ketokonazol \u2014 bezpe\u010dn\u00fd i p\u0159es omezen\u00ed peror\u00e1ln\u00ed formy.<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/clocip\/\"><strong>Clocip (clotrimazol 1% kr\u00e9m)<\/strong><\/a> \u2014 \u0160irokospektr\u00e9 lok\u00e1ln\u00ed antimykotikum.<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 18px;margin:24px 0;font-size:0.95em;\"><strong>Zdravotn\u00ed prohl\u00e1\u0161en\u00ed.<\/strong> Tato str\u00e1nka obsahuje informace o produktu pro dosp\u011bl\u00e9, kte\u0159\u00ed si objedn\u00e1vaj\u00ed antifung\u00e1ln\u00ed l\u00e9ky pro osobn\u00ed pot\u0159ebu. Nenahrazuje individu\u00e1ln\u00ed l\u00e9ka\u0159skou radu. Proberte vhodn\u00e9 antifung\u00e1ln\u00ed l\u00e9\u010divo, d\u00e1vkov\u00e1n\u00ed a d\u00e9lku l\u00e9\u010dby s kvalifikovan\u00fdm l\u00e9ka\u0159em \u2013 zejm\u00e9na pokud m\u00e1te onemocn\u011bn\u00ed jater, jste t\u011bhotn\u00e1 nebo koj\u00edte, u\u017e\u00edv\u00e1te warfarin, statiny, imunosupresiva nebo m\u00e1te pl\u00eds\u0148ovou infekci neht\u016f, kter\u00e1 m\u016f\u017ee b\u00fdt jinou diagn\u00f3zou (psori\u00e1za, lichen planus, trauma).<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<h5>\u2705 L\u00e9\u010d\u00ed \u0161irok\u00e9 spektrum pl\u00eds\u0148ov\u00fdch infekc\u00ed<br \/>\n\u2705 C\u00edl\u00ed na rezistentn\u00ed kmeny<br \/>\n\u2705 Snadn\u00e9 pou\u017eit\u00ed<\/h5>\n<p><span style=\"color: #999999;\">Ketocip obsahuje Ketoconazole<\/span><\/p>","protected":false},"featured_media":53707,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3501,3141,3504,3342],"product_tag":[3625,3623],"class_list":{"0":"post-53706","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-anti-fungal","7":"product_cat-category-overview","8":"product_cat-fungal-infection-treatment","9":"product_cat-general-health","10":"product_tag-ketocip","11":"product_tag-ketoconazole","13":"first","14":"outofstock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/53706","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=53706"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/53707"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=53706"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=53706"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=53706"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=53706"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}