# Ketoconazole in Nigeria

Ketoconazole has 94 active NAFDAC registrations in our October 2026 copy of the register, from 58 registration holders; 20 further listings have lapsed.

- Source: https://ogbogwu.com/drugs/ketoconazole/
- Drug class: Imidazole antifungal (Dermatology)
- Also known as: Nizoral, Ketokoz, Ketoderm
- Prescription required: no
- Last updated: October 2026

## Price in Nigeria

As of October 2026, Ketoconazole syrup sells for about ₦471 per ml online in Nigeria (packs ₦11,200–₦64,500; Nizoral) at MedPlus and Supermart.ng; cream ₦6,750–₦8,750. The online price is roughly unchanged since August 2026. Open-market prices (e.g. Idumota, Ogbogwu) are often lower.

## What is Ketoconazole?

Ketoconazole is an imidazole antifungal that kills or stops the growth of fungi and yeasts by disrupting their cell membranes. In Nigeria it is most familiar as a 2% cream and a 2% shampoo (the best-known brand being Nizoral) used on the skin and scalp, and it is one of the most widely stocked antifungal creams in pharmacies and patent-medicine shops. Our copy of the NAFDAC register lists dozens of active ketoconazole registrations, many of them creams made in Nigeria.

Applied to the skin, ketoconazole is effective and safe for common fungal problems: ringworm, jock itch, athlete's foot, the discoloured patches of pityriasis versicolor, and — as a cream or shampoo — dandruff and seborrhoeic dermatitis. Because the amount absorbed through the skin is tiny, the topical forms avoid the serious risks that come with the tablet.

The ketoconazole tablet is a very different matter. After reports of severe, sometimes fatal liver injury and dangerous hormone effects, medicines regulators in the US, Europe and elsewhere withdrew or severely restricted oral ketoconazole for fungal infections — safer tablets such as fluconazole and itraconazole are now used instead. Oral ketoconazole survives only for a few rare hormone-related conditions under specialist care. In Nigeria the tablet can still be found on sale, so it is worth being clear: for a skin or scalp fungus, the cream or shampoo is the right ketoconazole, not the tablet.

## What is Ketoconazole used for?

- Ringworm of the body (tinea corporis) and groin (tinea cruris / 'jock itch')
- Athlete's foot (tinea pedis)
- Pityriasis (tinea) versicolor — pale or dark uneven patches, common in Nigeria's humid climate
- Dandruff and seborrhoeic dermatitis of the scalp and face (cream or shampoo)
- Candidal intertrigo — yeast infection in warm skin folds
- Oral ketoconazole tablets: only for specific hormone-related conditions under specialist supervision — no longer recommended for ordinary fungal infections

## Dosage

Always follow a doctor's or pharmacist's instructions; this is general reference information.

- Adults: Cream: apply a thin layer to the affected skin and a small margin around it once or twice daily. Ringworm and jock itch usually need 2 to 4 weeks; athlete's foot and versicolor may need up to 4 to 6 weeks. Keep applying for a few days after the rash clears to prevent it coming back. Shampoo (for dandruff/seborrhoeic dermatitis): apply to wet scalp, leave for 3 to 5 minutes, then rinse — twice a week for 2 to 4 weeks, then once every week or two to keep it away. The oral tablet is not recommended for fungal infections and should only ever be taken under a specialist's direction.
- Children: The 2% cream can be used on children for fungal skin infections, applied thinly once or twice daily, ideally on a pharmacist's or doctor's advice for younger children. The shampoo can be used on the scalp with care to avoid the eyes. Oral ketoconazole should not be used in children.
- Elderly: The cream and shampoo need no dose change in older adults. As with anyone, avoid the oral tablet for fungal infection.

Wash and dry the area before applying the cream — fungi thrive in moisture, so keeping skin folds, feet and the groin dry is part of the treatment. Do not share towels or footwear, and treat athlete's foot and jock itch together as they often coexist. Avoid the eyes with both cream and shampoo. If a rash is spreading, weeping, or not improving after a few weeks, see a doctor — it may not be fungal, or may need an oral antifungal such as fluconazole.

## Side effects

Common: Mild burning, stinging or itching where the cream is applied; Redness or dryness of the treated skin; Scalp irritation or changes in hair texture with the shampoo; Rarely, a contact allergic reaction to the cream.

Serious (seek medical help immediately): Oral ketoconazole tablets: severe liver injury (including fatal cases) — the reason the tablet was withdrawn for fungal use in many countries; Oral tablets: dangerous heart-rhythm changes (QT prolongation) and interference with the body's steroid and testosterone production; Topical forms: severe allergic skin reaction (marked swelling, blistering) — uncommon; Signs of a spreading or bacterial skin infection needing different treatment.

When to see a doctor: For the cream or shampoo, stop and see a pharmacist or doctor if the skin becomes markedly more red, swollen, blistered or painful, or if there is no improvement after the expected treatment period. For anyone taking ketoconazole tablets, seek medical attention urgently for signs of liver trouble — yellow eyes or skin, dark urine, severe tiredness, nausea, pain in the upper right abdomen — and question why the tablet is being used at all for a fungal infection.

## Warnings

Do not take if: Known allergy to ketoconazole or other imidazole antifungals; Oral tablet: existing liver disease — a firm contraindication; Oral tablet: use for ordinary fungal infections is no longer recommended and is restricted or withdrawn in many countries; Broken or heavily weeping skin — get advice before applying cream.

Interactions: Topical cream and shampoo have negligible absorption and essentially no drug interactions; Oral ketoconazole (specialist use only) interacts dangerously with many medicines — statins, certain antihistamines, some heart and psychiatric drugs, and others — via strong inhibition of the liver's CYP3A4 enzyme; Oral ketoconazole with alcohol — added liver strain and, rarely, a disulfiram-like reaction.

Pregnancy & breastfeeding: The cream and shampoo are considered low-risk in pregnancy and breastfeeding because so little is absorbed through the skin; even so, use them only as needed and avoid applying cream to the breast area while nursing. Oral ketoconazole should be avoided in pregnancy and breastfeeding. When in doubt, ask a pharmacist or doctor.

## Brands in Nigeria

Well-known NAFDAC-registered brands: Nizoral Cream (Johnson & Johnson, made in Imported); Cika Ketoconazole Cream (Michelle Laboratories Limited, made in Nigeria); Conaz Cream (Jawa International Limited, made in Nigeria); Hyzoral Cream (Suitelife Pharmaceuticals Ltd, made in India); Nizoral Shampoo (Johnson & Johnson, made in Belgium); Obisoral (Obigod Pharmaceuticals Com Ltd, made in India).
Full searchable brand list: https://ogbogwu.com/drugs/ketoconazole/brands/

## How to verify it is genuine

1. Check the NAFDAC registration number on the tube or bottle — for example, Cika Ketoconazole Cream (Michelle Laboratories) carries A11-100354 in our copy of the register.
2. Verify any ketoconazole brand's number with our NAFDAC checker before paying.
3. For skin and scalp problems, buy the cream or shampoo — not the tablet; be cautious of anyone recommending ketoconazole tablets for a simple fungal infection.
4. Buy from a registered pharmacy and check the tube seal, batch number and expiry date; skin creams are a common target for repackaging and counterfeiting.
5. A NAFDAC-registered, locally made ketoconazole cream verified through the register is a reliable and usually affordable choice.

Verify any NAFDAC number free (no login): https://ogbogwu.com/nafdac-checker/

## FAQs

### What is ketoconazole cream used for?

Ketoconazole 2% cream treats fungal skin infections: ringworm on the body, jock itch in the groin, athlete's foot, the uneven patches of pityriasis versicolor, and yeast infections in skin folds. As a cream or shampoo it also helps dandruff and seborrhoeic dermatitis. You apply a thin layer to clean, dry skin once or twice a day, and keep going for a few days after it looks clear so it does not return.

### Is ketoconazole cream good for the face?

The cream and shampoo are used on the face for seborrhoeic dermatitis (the flaky, red areas around the nose, eyebrows and hairline) and for facial fungal infections, applied thinly and kept away from the eyes. It is not a skin-lightening or general 'fairness' cream, and it should not be used that way. If facial skin becomes more irritated rather than better, stop and ask a pharmacist or doctor — not every facial rash is fungal.

### Why are ketoconazole tablets dangerous?

Oral ketoconazole was found to cause severe, occasionally fatal liver damage, dangerous heart-rhythm changes, and disruption of the body's hormone production. Because safer antifungal tablets like fluconazole and itraconazole exist, regulators in the US, Europe and elsewhere withdrew or heavily restricted ketoconazole tablets for fungal infections. For a skin or scalp fungus you should be using the cream or shampoo, which is safe — the tablet is not the right tool.

### How long does ketoconazole take to clear ringworm?

With regular use of the 2% cream, ringworm and jock itch usually improve within one to two weeks and clear over two to four weeks; athlete's foot and pityriasis versicolor can take four to six weeks. The most common reason it 'fails' is stopping too early — keep applying for several days after the skin looks normal. Keeping the area clean and dry, and not sharing towels, speeds recovery and prevents recurrence.

### What is the difference between ketoconazole and clotrimazole?

Both are imidazole antifungal creams used for very similar skin infections — ringworm, jock itch, athlete's foot and yeast rashes — and either is a reasonable choice for common fungal skin problems. Ketoconazole is also widely used as an anti-dandruff shampoo. They are broadly interchangeable for skin use; a pharmacist can help you pick based on what is available and affordable. Persistent or widespread infections may need an oral antifungal like fluconazole instead.

## Sources

- NAFDAC Greenbook (official register of approved products in Nigeria)
- British National Formulary (BNF)
- Nigerian Standard Treatment Guidelines (Federal Ministry of Health)