Indications:
●Dandruff Blastomycosis
● Seborrheic Dermatitis
● Recalcitrant Dermatophytosis
● Histoplasmosis
Mechanism:
Ketoconazole, similarly to other azole antifungals, is a fungistatic agent which causes growth arrest in fungal cells thereby preventing growth and spread of the fungus throughout the body. Ketoconazole interacts with 14-α-sterol demethylase, a cytochrome P-450 enzyme necessary for the conversion of lanosterol to ergosterol. This results in inhibition of ergosterol synthesis and increased fungal cellular permeability due to reduced amounts of ergosterol present in the fungal cell membrane. This metabolic inhibition also results in accumulation of 14α-methyl-3,6-diol, a toxic metabolite. The increase in membrane fluidity is also thought to produce impairment of membrane-bound enzyme systems as components become less closely packed.
Zinc Pyrithione has a broad antimicrobial spectrum of activity, including fungi, gram-positive and gram-negative bacteria. Inhibition of fungal growth by pyrithione zinc is linked to increased copper uptake and cellular levels of copper, which is demonstrated by decreased CTR1-lacZ expression and slightly increased CUP1-lacZ expression in affected microorganisms. The coordination complex of pyrithione zinc dissociates, and pyrithione ligand forms a CuPT complex from available extracellular copper in the target organism. Pyrithione acts as an ionophore, interacting nonspecifically with the plasma membrane to shuttle copper into the cell, and facilitates copper transport across intracellular membranes. Copper may be shuttled into the mitochondria. Copper inactivates iron-sulfur (Fe-S) cluster-containing proteins via a mechanism similar to that described for copper-induced growth inhibition in bacteria. Decreased activity of Fe-S proteins leads to inhibition of fungal metabolism and fungal growth. Pyrithione zinc has been shown to slightly increase the levels of zinc.
Side Effects:
The shampoo is considered as safe when used in recommended doses however dry skin, abnormal hair texture, scalp pustules and rashes can be observed in some patients.
Interactions:
Pyrithione zinc may interact with adapalene, alitretinoin, isotretinoin, tretinoin,tazarotene.
Contraindications:
Not to be used in patients with hypersensitivity to any of the ingredients
Precautions & Warnings:
●Do not use this medicine for a skin problem that has not been checked by your doctor
● The foam form of this medicine may make your skin more sensitive to sunlight. Use sunscreen when you are outdoors. Avoid sunlamps and tanning beds
● This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing
How to use:
● Wet your hair and scalp well with water
● Apply the shampoo to the skin of the affected area and a wide margin surrounding this area
● Work up a good lather and leave it in place for 5 minutes
● Rinse your hair and scalp well with warm water, and dry your hair
Storage:
Store at room temperature. Keep all drugs out of the reach of children and pets.