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Except under special circumstances, this medication should not be used when the following medical problem exists: Hypersensitivity to azole antifungals.
Risk-benefit should be considered when the following medical problems exist: Achlorhydria or Hypochlorhydria (may cause marked reduction in absorption of Ketoconazole; patients with acquired immunodeficiency syndrome [AIDS] may have reduced Ketoconazole absorption due to hypochlorhydria).
Alcoholism, active or in remission or Hepatic function impairment (azole antifungals are metabolized in the liver and may infrequently be hepatotoxic; azole antifungals, especially Ketoconazole, should be used with caution in patients with pre-existing liver function impairment, those who have experienced liver toxicity with other medications, or a history of alcoholism). Ketoconazole has also been reported to cause a disulfiram-like reaction to alcohol, characterized by flushing, rash, peripheral edema, nausea and headache; symptoms resolved within a few hours.
