Topical antifungal Topically administered<unk>  is usually prescribed for fungal infections of the skin and mucous membranes, such as athlete's foot, ringworm, candidiasis (yeast infection or thrush), jock itch, and tinea versicolor. Topical<unk>  is also used as a treatment for dandruff (seborrheic dermatitis of the scalp) and for seborrheic dermatitis on other areas of the body, perhaps acting in these conditions by suppressing levels of the fungus Malassezia furfur on the skin. Systemic antifungal<unk>  has activity against many kinds of fungi that may cause human disease, such as Candida, Histoplasma, Coccidioides, and Blastomyces (although it is not active against Aspergillus), chromomycosis and paracoccidioidomycosis. First made in 1977,<unk>  was the first orally-active azole antifungal medication. However,<unk>  has largely been replaced as a first-line systemic antifungal medication by other azole antifungal agents, such as itraconazole, because of<unk> 's greater toxicity, poorer absorption, and more limited spectrum of activity.<unk>  is used orally in dosages of 200 to 400 mg per day in the treatment of superficial and deep fungal infections. Off-label uses Hair loss<unk>  2% gel<unk>  shampoo in conjunction with an oral 5α-reductase inhibitor such as finasteride or dutasteride has been used off label to treat androgenic alopecia. It was speculated that antifungal properties of<unk>  reduce scalp microflora and consequently may reduce follicular inflammation that contributes to alopecia. Limited clinical studies suggest<unk>  shampoo used either alone or in combination with other treatments may be useful in reducing hair loss in some cases. Hormonal The side effects of<unk>  are sometimes harnessed in the treatment of non-fungal conditions. While<unk>  blocks the synthesis of the sterol ergosterol in fungi, in humans, at high dosages (>800 mg/day), it potently inhibits the activity of several enzymes necessary for the conversion of cholesterol to steroid hormones such as testosterone and cortisol. Specifically,<unk>  has been shown to inhibit cholesterol side-chain cleavage enzyme, which converts cholesterol to pregnenolone, 17α-hydroxylase and 17,20-lyase, which convert pregnenolone into androgens, and 11β-hydoxylase, which converts 11-deoxycortisol to cortisol. All of these enzymes are mitochondrial cytochrome p450 enzymes. Based on these antiandrogen and antiglucocorticoid effects,<unk>  has been used with some success as a second-line treatment for certain forms of advanced prostate cancer and for the suppression of glucocorticoid synthesis in the treatment of Cushing's syndrome. However, in the treatment of prostate cancer, concomitant glucocorticoid administration is needed to prevent adrenal insufficiency.<unk>  has additionally been used, in lower dosages, to treat hirsutism and, in combination with a GnRH analogue, male-limited precocious puberty. In any case, the risk of hepatotoxicity with<unk>  limits its use in all of these indications, especially in those that are benign such as hirsutism.<unk>  has been used to prevent the testosterone flare at the initiation of GnRH agonist therapy in men with prostate cancer.
Ketoconazole
Levoketoconazole
Itraconazole
Sertaconazole
Miconazole
Terbinafine
Efinaconazole
Posaconazole