Kz LOTION – IS IT SAFE? USES, SIDE EFFECTS, DOSAGE

What is Kz lotion?

Kz lotion is a synthetic anti-fungal lotion used for the treatment of yeast and fungal infections and for many other purposes. It belongs to the family of Azole Antifungals.

The active ingredient is broad spectrum anti-fungal agent, Ketoconazole present in strength 2%.

The inactive ingredients  are :

• Propylene glycol
• Cetyl alcohol
• Sorbitan Monostearate
• isopropyl myristate
• Polysorbate 80
• Water
• Stearyl alcohol
• Polysorbate 60
• Sodium Sulfite

It is available in form of Cream for topical use.

It is manufactured by Hegde and Hegde pharmaceutical LLP.

Kz LOTION -IS IT SAFE? USES, SIDE EFFECTS, DOSAGE

What is the Generic name(s)?
How does it work?
What are its uses?
Who should not use Kz lotion?
How effective is this medicine?
Is it addictive?
What is the dosage?
What if I miss a dose?
What to do in case of overdosage?
What to do if there is an allergic reaction?
What are the side effects?
Does this medicine has any drug interactions?
How to use kz lotion?
Precautions
Is it safe to use if I am pregnant?
Is it safe to use if I am breastfeeding?
Can this medicine be given to children and infants?
Is this medicine available as over the counter product?
Frequently asked questions
Reference

What is the Generic name(s)?

The generic name for Kz lotion is Ketoconazole.

How does it work?

Kz lotion interferes with the formation of the cell membrane of fungus and thus affects the protective layers and weakens the microorganism. It basically interferes with synthesis of ergosterol which is an integral component of cell membrane. This inhibition is brought about by inhibition of enzyme cytochrome P-450 dependent enzyme, Lanosterol 14-a demethylase which converts lanosterol to ergosterol.

What are its uses?

It is used for the treatment of:

1. Fungal infections(on the skin, mucous membrane and nails)like:

• Chromomycosis – This infection will affect the skin and subcutaneous tissue(Caused by Fonsecaea Pedrosoi or Phialophora Verrucosa)
• Blastomycosis – It will affect the joints, bones and skin(Caused by Blastomyces dermatitidis)
• Paracoccidomycosis(Caused by Paracoccidioides brasiliensis)
• Coccidioidomycosis (Caused by Coccidiodes)
• Histoplasmosis (Caused by Histoplasma Capsulatum); the last 3 conditions affect lungs and other parts of the body.
• Pityriasis-condition which causes lightening of legs, arms, neck, etc.
• Tinea corporis(Ringworm) – A superficial infection which appears on arms, lower limbs and skin
• Tinea Pedis(Athlete’s foot) – Infection on foot
• Tinea Cruris(Jock itch) – Infection in groin and buttocks.
• Candidiasis – White patches on the affected area

2. Certain kinds of dandruff seen in immunocompetent children(below 12 years) and adults.
3. Yeast infections like Seborrheic Dermatitis.
4. Treatment of certain skin conditions which become worse with fungal infections like Eczema(caused due to allergies), diaper rash and impetigo( blisters formed due to infection)

Who should not use Kz lotion?

Kz lotion is contradicted in individuals with:

• Hypersensitivity to active ingredient Ketoconazole or any other previously consumed imidazole antifungal drugs.
• Pre-existing acute or chronic liver disease
• QT prolongation (acquired or congenital) history
• Porphyria
• Decreased testosterone levels
• Stomach acid-related conditions
• Decreased function of the adrenal gland
• Drug-induced Hepatitis
• Very rapid heartbeat

How effective is this medicine?

Kz lotion is prescribed very frequently as an anti-fungal cream due to its rapid onset and its broad spectrum action. It reaches its peak effect in 1 to 2 hours. The average duration of action of the medicine is about 8 hours. Treatment using this drug is very easy and satisfactory.

Is it addictive?

There are no habit-forming tendencies reported with this medicine.

What is the dosage?

For cutaneous Candidiasis, Tinea Pedis, Tinea corporis, Tinea Cruris and Pityriasis:

Apply the cream once a day to cover the entire affected area and also the adjacent areas.

Cutaneous Candidiasis, Tinea corporis, Tinea Cruris and Pityriasis: The cream should be applied for two weeks or as the physician suggests.

Tinea Pedis: The treatment period is 6 weeks.

For Seborrheic Dermatitis:

The cream should be applied twice in a day on the affected areas.

The duration of treatment is at least 4 weeks or the duration the physician will suggest.

If the patient shows no improvement clinically, the dosage parameters are to be reconsidered and changed accordingly.

Dosage considerations:

In the case of renal impairment: No dosage adjustment is required

In case of liver impairment: Though systemic absorption through topical route is considerably less, hepatotoxicity can still result. Therefore dose adjustments in individuals with hepatic impairment are essential.

The strength and duration of the dose may vary as per the doctor’s observations according to individual condition and can be adjusted according to renal and liver status.

How to use Kz lotion?

The lotion is only meant for external use. Shake the medicine well and apply an even layer and on the affected area and on the adjacent parts. Rub it gently with clean hands. Apply it according to the prescribed dosage and duration.

What if I miss a dose?

In case one misses a dose, it should be taken as soon as the patient remembers it. If it is already time for the next dose, skip the missed dose. Do not take the double dose.

What to do in case of overdosage?

• Overdosage in males can lead to a reduction in testosterone and sperm count levels.
• Using more quantity of cream can lead to pilling. To avoid that, apply the cream in a thin layer or use in a lesser quantity.
• If you think that you have taken more tablets than the dosage prescribed, call emergency medical help or the poison control centre immediately. The treatment will be symptomatic and supportive. In the first hour, activated charcoal might be given.

What to do if there is an allergic reaction?

Ketoconazole has a compound, sodium sulfate anhydrous which is a sulfite and may cause a reaction and lead to anaphylactic symptoms and also very rarely, asthmatic episodes in certain predisposed individuals. This Sulfite sensitivity is more commonly seen in asthmatic than non-asthmatic people. Call for help immediately if these symptoms are:

• Chest tightness
• Wheezing
• Gray or blue skin colour
• Severe belly pain
• Fever
• Not being able to eat
• Itching
• Dark urine/yellow eyes or skin
• Seizures
• Diarrhoea
• Swelling of lips, throat or tongue
• Vomiting
• Feeling of fatigue
• Fast and pounding heartbeats

What are the side effects?

Through the topical route, the side effects are:

• Itching
• Pruritus and stinging
• Burning sensation of skin
• Ingestion
• Decreased platelet count
• Rashes on skin
• Nausea
• Tingling sensation
• Inability to have an erection
• Bleeding
• Dryness
• Synthesis of adrenal gland hormones is blocked leading of deficiencies.
• Photophobia
• Tenderness
• Redness
• Swelling
• Pain at the affected area
• Warmth at the affected area

Usually most side effects stated above not require any medical attention. The body of the patient gets adapted to the cream and eventually, the effects fade away. Also, the dermatologist or the doctor will mostly inform the patient about these side effects and also ways of reducing them.

There are certain uncommon side-effects:

• Skin exfoliation
• Contact dermatitis
• Sticky skin
• Bullous eruption

If these side effects are seen, stop the treatment immediately and report it to the doctor.

Does this medicine has any drug interactions?

Kz lotion can interact with the following drugs:

• Beclomethasone
• Cisapride
• Artesunate
• Abiraterone acetate
• Fexofenadine
• Corticotropin
• Erlotinib
• Alprazolam
• Didanosine
• Desonide
• Eplerenone
• Carbamazepine
• Cyclosporin A
• Aluminium oxide and hydroxide
• Astemizole
• Felodipine
• Aliskiren
• Dabigatran
• Nisoldipine
• Flunisolide
• Amphotericin B
• Dronedarone
• Famotidine
• Pimozide
• Bosentan
• Oral Midazolam
• Indinavir
• Aprepitant
• Alfentanil
• Cimetidine
• Tolvaptan
• Erythromycin
• Colchicine
• Docetaxel
• Clopidogrel
• Atorvastatin, Lovastatin, Simvastatin
• Warfarin
• Ergot alkaloids
• Quinidine
• Irinotecan
• Methadone

 Precautions

• Inform your doctor or dermatologist about all the current medicines, oral supplements (even herbal and Ayurvedic) and vitamins that you have been consuming.
• Also, let the doctor know about any upcoming surgeries or pregnancies.
• Wash hands before and after applying the cream.
• Wash the affected area first and then dry it before applying the cream.
• Do not bandage the area after applying the cream.
• Do not wash the affected area after applying the cream.
• Kz lotion is not for ophthalmic use
• Do not apply other ointments or lotions after using Kz lotion as it can give rise to interactions with the ingredients and cause unwanted adverse effects.
• Consult the doctor before applying the medicine in areas with open wounds, irritation and sunburn.
• Avoid scratching the infected area.
• Avoid getting the cream in eye or nose.
• Maintain proper hygiene to get rid of the fungal infection quickly. Also, avoid sources of reinfection.
• Get liver function test done on a regular basis as recommended by the doctor to avoid hepatotoxicity later. If the Alanine aminotransferase (ALT) levels increase 30% above the base or reach the upper limit or if symptoms of liver damage are observed, the treatment is stopped immediately.

Is it safe to use if I am pregnant?

US FDA has declared this drug as a category C medicine due to the lack of controlled clinical studies in humans. Studies performed on animals proved Kz lotion to be teratogenic and embryotoxic. It will be prescribed by the doctor if it is of utmost importance, if there are no alternatives and if the benefits of the drug justify all the risks to the fetus. Do not use Kz lotion without first informing your doctor that you are pregnant.

Is it safe to use if I am breastfeeding?

The active ingredients of the medicine can be excreted into human milk and harm the baby. Using the lotion topically might not result in significant absorption in the breasts to be detected in human milk. Nevertheless, inform the doctor if you are breastfeeding and discuss the potential risks and benefits. It will be then prescribed if it is absolutely necessary. If the lotion is applied near the chest area of the mother, make sure that during breastfeeding the infant does not consume the medicine. To avoid exposure to the medicine at all, avoid feeding milk for at least 5 hours after applying the medication.

Can this medicine be given to children and infants?

Kz lotion has been used for paediatric purposes off-label but it is not FDA approved for use in patients below 12 years. If it is necessary to be applied, consult a paediatrician first and use only then.

Is this medicine available as over the counter product?

No. A prescription from a doctor is essential for purchasing this medicine.

Notes: 

• In conditions like Pityriasis, the skin colour will not return to normal immediately after the infection has subsided. If can take a couple of months after the treatment to return to the usual colour.
• The medicine prescribed is for current condition only. Do not use it in the future for other similar conditions, if they arise.
• Do not share the lotion with anyone, even if they have the same infection.
• Do not flush the medication when it expires or when you have completed the course. Follow the doctor’s advice for its proper disposal.

Frequently asked questions

Q: Is there any dietary related instructions to be followed while taking Kz lotion tablets?

No dietary modifications are essential unless said to do so by your doctor or dermatologist.

Q: How should the lotion be stored?

• The lotion should be stored at room temperature.
• It should not be exposed to direct sunlight and should be kept dry.
• Do not keep it in the bathroom.
• Do not let it freeze.
• It must be kept away from the reach of children and pets.

Q: My fungal infection has vanished. Can I stop taking this medicine?

No. Do not stop the medicine just because the symptoms have disappeared. There could still be a residual infection which is not visible to the naked eye and will grow over time if the medicine is stopped. Complete the course of the treatment. Consult your physician for advice on what is to be done.

Q: I applied the expired dose of Kz lotion. What should I do?

Usually taking one expired dose cannot do any harm as no adverse effects manifest in a single dose. However, you are advised to discuss this with your doctor.

Q: What is the cost of Kz lotion cream?

The price of the cream ranges from 180-250 INR. A prescription will be required to buy this medicine.

Q: Can I drive after applying Kz lotion?

After applying the lotion, some side effects like nausea and dizziness can result. Thus driving can be dangerous at this time and should be avoided strictly.

Q: How long do I need to apply Kz lotion?

The duration of your treatment will depend on the severity and spread of the infection. Follow the duration as told by your doctor and after its completion, visit the doctor for follow up.

Q: Can I apply Kz lotion at bedtime?

Yes, the lotion can be applied at any time during the day. However, try and apply the lotion at the same time every day since it would give better results.

Q: Can the lotion be used to treat Psoriasis?

This lotion is not warranted to treat Psoriasis as it is not a fungal infection. Take advice from the doctor or dermatologist for prescribing the medicine and treating the condition.

Reference

Wikipedia page on Antifungal

 

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