Explain Adverse Effects of ketoconazole

Anorexia, nausea and vomiting are common with higher doses (>400 mg/day) of ketoconazole; taking the drug with food or at bedtime may improve tolerance. Pruritus, rash and dizziness may occur. Ketoconazole can decrease plasma testosterone concentrations and cause gynecomastia, decreased libido and loss of potency in men and menstrual irregularities in women. High doses may inhibit adrenal steroidogenesis and reduce plasma cortisol concentrations. Mild hepatic toxicity is fairly common with ketoconazole. If jaundice or symptoms of hepatitis appear, the drug should be stopped promptly or fatal hepatic necrosis may happen.