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Xolegel

ketoconazole

Used for Seborrheic Dermatitis

Xolegel (ketoconazole) is a good choice for treating seborrheic dermatitis, but shouldn't be used if you have a weakened immune system.

Reviewed by:

Christina Aungst, PharmD

Michelle Nguyen, PharmD

Last reviewed on March 29, 2021

Basics Side effects Pros & cons Pharmacist tips FAQs Warnings Dosage Interactions Cost Latest news Images Prices Medicare

What is Xolegel (ketoconazole)?

What is Xolegel (ketoconazole) used for?

Seborrheic dermatitis

How Xolegel (ketoconazole) works

Xolegel (ketoconazole) is an antifungal gel but experts aren't sure exactly how it works to treat seborrheic dermatitis as the condition is not caused by a fungus.

Are you looking for information on Extina (ketoconazole foam), Ketozole (ketoconazole cream), or ketoconazole tablet instead?

Drug Facts

Common BrandsXolegel

Drug ClassAntifungal

Controlled Substance ClassificationNot a controlled medication

Generic StatusNo lower-cost generic available

AvailabilityPrescription only

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Avg retail price

$1016.24(save 18.05%)

GoodRx discount

$832.82

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What are the side effects of Xolegel (ketoconazole)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Burning where Xolegel (ketoconazole) was applied (4%)

Other Side Effects

Dry skin
Redness
Irritation
Pain
Itching

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.

Allergic reaction (rash, swelling of face, tongue, or throat, difficulty breathing)

Source: FDA

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common—For cream, shampoo, foam, or gel

Itching, stinging, burning, or irritation not present before use of this medicine

Rare—For cream, foam, or gel

Acne

bleeding from sore in the mouth

blistering, crusting, irritation, itching, or reddening of the skin

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

cracked, dry, or scaly skin

discoloration of the fingernails or toenails

dizziness

eye dryness, irritation, or swelling

red rash with watery, yellow-colored, or pus filled blisters with or without thick yellow to honey-colored crusts

skin dryness, pain, rash, redness, or swelling

sore in the mouth or on the gums

swelling of the face

Rare—For shampoo

Hair loss and irritation

Incidence not known—For gel

Pain

Incidence not known—For shampoo

Blistering, burning, crusting, dryness, or flaking of the skin

burning sensation of the skin

burning, itching, redness, skin rash, swelling, or soreness at the application site

discoloration of the hair

dry skin

fast heartbeat

fever

hives

hoarseness

irritation

itching, scaling, severe redness, or soreness of the skin

joint pain, stiffness, or swelling

rash

shortness of breath

swelling of the eyelids, face, lips, hands, or feet

thinning of the hair

tightness in the chest

troubled breathing or swallowing

wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common—For shampoo or gel

Dryness or oiliness of the hair and scalp

headache

Rare—For shampoo

Abnormal hair texture

mild dryness of the skin

scalp pustules

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Pros and cons of Xolegel (ketoconazole)

Pros

Works well

Easy to use

Only has to be used once a day

Works faster than other topical forms of ketoconazole

Cons

Not approved for children under 12 years old

Not approved for people with compromised immune systems

No generic available, so can be very expensive

Pharmacist tips for Xolegel (ketoconazole)

Wash and dry your hands well before applying Xolegel (ketoconazole). Apply a thin layer to all affected areas using your fingertips to rub it in. Don't wash the areas where you've applied Xolegel (ketoconazole) for at least 3 hours, and wait 20 minutes before you apply sunscreen or makeup.

Xolegel (ketoconazole) is flammable. Avoid fire, flames, or smoking during and after applying Xolegel (ketoconazole). Store your carton in a cool, dry place away from sources of heat.

Wash your hands well after using Xolegel (ketoconazole) to prevent it from getting in your eyes, mouth, nose, or vagina. If Xolegel (ketoconazole) does accidentally get in one of these areas, rinse it with water right away.

Use Xolegel (ketoconazole) for a maximum of 2 weeks. Don't use Xolegel (ketoconazole) for longer than your healthcare provider has prescribed. If you see no improvement after 2 weeks, let your healthcare provider know. You may need a different medication.

If you are breastfeeding, don't apply Xolegel (ketoconazole) to the nipples or areolas. This will help prevent your child from getting Xolegel (ketoconazole) in their mouth. Please let your healthcare provider know if you feel you need medication for these areas.

Frequently asked questions about Xolegel (ketoconazole)

Why is Xolegel (ketoconazole) not approved for children under 12?

The studies for Xolegel (ketoconazole) were only done with people ages 12 and older. Researchers do not know if children under 12 will have the same reactions to Xolegel (ketoconazole). Because of this, the FDA has only approved it for people aged 12 and up.

Why is Xolegel (ketoconazole) not approved for people with weakened immune systems?

Many times, people with compromised immune systems react to medications differently than those with healthy immune systems. Xolegel (ketoconazole) was not studied in people with weakened immune systems, so experts don't know if Xolegel (ketoconazole) would have the same effect. Because of this, the FDA has only approved it for people with healthy immune systems.

Is Xolegel (ketoconazole) a steroid?

No, Xolegel (ketoconazole) is not a steroid. It is an antifungal. Many people will be prescribed Xolegel (ketoconazole) and a steroid at the same time because they can be both be used to treat seborrheic dermatitis.

Can Xolegel (ketoconazole) damage the liver?

No, Xolegel (ketoconazole) is not absorbed into the blood stream when used as a gel, so it does not affect the liver at all.

Can I use Xolegel (ketoconazole) on my face?

You should only apply Xolegel (ketoconazole) where your healthcare provider instructs you to. If you need to apply Xolegel (ketoconazole) to your face, you can do so, just be careful to avoid getting it in your eyes, nose, or mouth. Xolegel (ketoconazole) will cause a lot of irritation to these areas.

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What are the risks and warnings for Xolegel (ketoconazole)?

Xolegel (ketoconazole) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

FLAMMABLE PRODUCT

Xolegel (ketoconazole) contains flammable ingedients. Stay away from fires or open flames and don't smoke during and immediately after using Xolegel (ketoconazole). Avoid getting the Xolegel (ketoconazole) carton close to fires, flames, or other heat sources. Even if the Xolegel (ketoconazole) container is empty, don't throw it into a fire.

SKIN IRRITATION

Xolegel (ketoconazole) can cause irritation where you apply it. If this irritation happens or your dermatitis symptoms get worse while using Xolegel (ketoconazole), talk to your healthcare provider. Do not stop using it unless your provider tells you to do so.

Xolegel (ketoconazole) dosage forms

The average cost for 1 tube of 45g of 2% of Xolegel (ketoconazole) is $832.82 with a free GoodRx coupon. This is 18.05% off the average retail price of $1016.24.

Tube of gel

Dosage	Quantity	Price as low as	Price per unit
45g of 2%	1 tube	$832.82	$832.82

Typical dosing for Xolegel (ketoconazole)

Apply Xolegel (ketoconazole) to the affected areas once daily for 2 weeks.

Interactions between Xolegel (ketoconazole) and other drugs

Xolegel (ketoconazole) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Xolegel (ketoconazole). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.