<unk>  is a synthetic imidazole. It is a nonsteroidal compound. It is a racemic mixture of two enantiomers, levoketoconazole ((2S,4R)-(−)-ketoconazole) and dextroketoconazole ((2R,4S)-(+)-ketoconazole). Levoketoconazole is under development for potential clinical use as a steroidogenesis inhibitor with better tolerability and less toxicity than<unk> . Other steroidogenesis inhibitors besides<unk>  and levoketoconazole include the nonsteroidal compound aminoglutethimide and the steroidal compound abiraterone acetate. History<unk>  was discovered in 1976 at Janssen Pharmaceuticals. It was patented in 1977, followed by introduction in the United States in July 1981. Following its introduction,<unk>  was the only systemic antifungal available for almost a decade.<unk>  was introduced as the prototypical medication of the imidazole group of antifungals. Oral<unk>  has been replaced with oral itraconazole for many mycoses. Due to incidence of serious liver toxicity, the use of oral<unk>  was suspended in France in July 2011 following review. This event triggered an evaluation of oral<unk>  throughout the rest of the European Union as well. In 2013, oral<unk>  was withdrawn in Europe and Australia, and strict restrictions were placed on the use of oral<unk>  in the United States and Canada. Oral<unk>  is now only indicated for use in these countries when the indication is a severe or life-threatening systemic infection and alternatives are unavailable. However, topical<unk> , which does not distribute systemically, is safe and widely used still.<unk>  HRA was approved for use in the European Union for treatment of Cushing's syndrome in November 2013. As of March 2019, oral levoketoconazole (developmental code name COR-003, tentative brand name Recorlev) is phase III clinical trials for the treatment of Cushing's syndrome. Oral levoketoconazole may have a lower risk of liver toxicity than oral<unk> .
Ketoconazole
Levoketoconazole
Itraconazole
Sertaconazole
Miconazole
Terbinafine
Efinaconazole
Posaconazole