Ketomax 400mg Tablet: Complete Medicine Guide
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Yellowing of skin or eyes (jaundice)
- Dark urine or pale stools
- Severe abdominal pain
- Persistent nausea or vomiting
- Unusual fatigue or weakness
- Severe skin rash or blistering
- Swelling of face, lips, or throat
- Difficulty breathing
- Irregular heartbeat or palpitations
If experiencing severe symptoms, call emergency services immediately.
What is ketomax 400mg tablet used for?
Ketomax 400mg tablet contains ketoconazole, an antifungal medicine used to treat serious systemic fungal infections. It works by damaging the fungal cell membrane. It requires a prescription and regular liver monitoring due to the risk of liver toxicity.
- Generic Name: Ketoconazole (400mg)
- Manufacturer: Betamax Remedies
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 ketomax 400mg tablet के बारे में (Hindi Summary)
उपयोग: यह दवा कीटोकोनाज़ोल 400 मिलीग्राम की गोली है, जिसका उपयोग गंभीर फंगल संक्रमणों के इलाज के लिए किया जाता है। यह ब्लास्टोमाइकोसिस, कोक्सीडियोइडोमाइकोसिस, हिस्टोप्लाज्मोसिस जैसे गंभीर फंगल संक्रमणों में प्रभावी है। यह दवा फंगस की कोशिका भित्ति को नष्ट करके उसका विकास रोकती है। यह केवल डॉक्टर के पर्चे पर ही ली जानी चाहिए और इसके सेवन के दौरान लीवर की नियमित जांच आवश्यक है।
साइड इफेक्ट्स: आम दुष्प्रभावों में मतली, उल्टी, पेट दर्द, सिरदर्द, चक्कर आना और दाने शामिल हैं। गंभीर दुष्प्रभावों में लीवर की क्षति, अधिवृक्क अपर्याप्तता और गंभीर त्वचा प्रतिक्रियाएं शामिल हैं। यदि आपको पीलिया, गहरे रंग का मूत्र, या लगातार मतली का अनुभव हो, तो तुरंत डॉक्टर से संपर्क करें।
सुरक्षा सलाह: इस दवा को केवल डॉक्टर की देखरेख में ही लें। इलाज से पहले और दौरान लीवर फंक्शन टेस्ट करवाना जरूरी है। शराब का सेवन बिल्कुल न करें क्योंकि इससे लीवर को नुकसान का खतरा बढ़ सकता है। एंटासिड या अन्य दवाओं के साथ लेने से पहले डॉक्टर से सलाह लें। यदि आपको गंभीर थकान, पेट दर्द, या आंखों का पीला होना महसूस हो, तो तुरंत डॉक्टर से मिलें।
💊 ketomax 400mg tablet Uses & Benefits
[{"condition":"Blastomycosis","description":"Treatment of pulmonary and extrapulmonary blastomycosis in patients who cannot tolerate other antifungals.","evidence":"Well-established"},{"condition":"Coccidioidomycosis","description":"Treatment of progressive coccidioidomycosis, including pulmonary and disseminated forms.","evidence":"Well-established"},{"condition":"Histoplasmosis","description":"Treatment of chronic pulmonary and disseminated histoplasmosis.","evidence":"Well-established"},{"condition":"Chromomycosis","description":"Treatment of chromomycosis (chromoblastomycosis) caused by various fungi.","evidence":"Well-established"},{"condition":"Paracoccidioidomycosis","description":"Treatment of paracoccidioidomycosis, a systemic fungal infection.","evidence":"Well-established"},{"condition":"Chronic mucocutaneous candidiasis","description":"Management of chronic mucocutaneous candidiasis in patients unresponsive to topical therapy.","evidence":"Well-established"},{"condition":"Recalcitrant dermatophyte infections","description":"Treatment of severe or resistant dermatophyte infections of skin and nails.","evidence":"Moderate"}]
Off-label uses: [{"condition":"Cushing's syndrome","description":"Sometimes used off-label to reduce cortisol production in Cushing's syndrome due to adrenal enzyme inhibition.","evidence":"Limited"},{"condition":"Prostate cancer","description":"Investigated for use in castration-resistant prostate cancer due to its ability to inhibit androgen synthesis.","evidence":"Limited"},{"condition":"Advanced prostate cancer","description":"Used off-label in some settings to suppress adrenal androgen production.","evidence":"Limited"}]
Primary treatment for: Systemic fungal infections
Also treats: Blastomycosis, Coccidioidomycosis, Histoplasmosis, Chromomycosis, Paracoccidioidomycosis, Chronic mucocutaneous candidiasis
📋 Drug Information
| Generic Name(s) | Ketoconazole (400mg) |
| Brand Name | ketomax 400mg tablet |
| Manufacturer | Betamax Remedies |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | OPHTHAL OTOLOGICALS |
| Action Class | Fungal ergosterol synthesis inhibitor |
| Route of Administration | Oral |
| Storage | Store at room temperature between 15°C and 30°C (59°F to 86°F). Keep in a tightly closed container, protected from light and moisture. |
| Shelf Life | 24 months from the date of manufacture. |
| WHO Guideline | Not established from the available information. |
| ICMR Guideline | Not established from the available information. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
Ketoconazole inhibits the cytochrome P450 enzyme 14α-demethylase (CYP51A1), which is responsible for converting lanosterol to ergosterol, a critical component of fungal cell membranes. This inhibition leads to increased permeability and leakage of cellular contents, ultimately causing fungal cell death. In humans, ketoconazole also inhibits several cytochrome P450 enzymes, which accounts for many of its drug interactions and endocrine effects.
Mechanism Steps
💡 How to Take ketomax 400mg tablet
Strength: 400 mg immediate-release tablet
Dosage Information
| Adult Dosage | The usual adult dose for systemic fungal infections is 200 mg to 400 mg once daily, taken with food. For severe infections, the dose may be increased to 400 mg twice daily. The duration of treatment depends on the infection and clinical response. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | Elderly patients may be more sensitive to the effects of ketoconazole. Dose selection should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or other drug therapy. |
| Renal Impairment | No specific dosage adjustment is provided in the manufacturer's labeling for renal impairment. However, ketoconazole is extensively metabolized, and renal impairment is unlikely to significantly affect its clearance. Use with caution and monitor for adverse effects. |
| Hepatic Impairment | Ketoconazole is contraindicated in patients with acute or chronic liver disease. In patients with mild hepatic impairment, use with extreme caution and monitor liver function closely. Dose reduction may be necessary. |
| Maximum Daily Dose | The maximum recommended daily dose is 800 mg (400 mg twice daily) for severe infections. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of ketomax 400mg tablet
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Cisapride | Major | |
| Terfenadine | Major | |
| Astemizole | Major | |
| Midazolam | Major | |
| Triazolam | Major | |
| Statins | Major | |
| Warfarin | Major | |
| Rifampin | Major | |
| Antacids | Moderate | |
| Proton pump inhibitors | Moderate |
🚨 Major Interactions
- Cisapride
- Terfenadine
- Astemizole
- Midazolam
- Triazolam
- HMG-CoA reductase inhibitors (statins)
- Warfarin
- Rifampin
- Isoniazid
⚡ Moderate Interactions
- Antacids
- H2 blockers (e.g., ranitidine)
- Proton pump inhibitors (e.g., omeprazole)
- Phenytoin
- Cyclosporine
- Oral hypoglycemics
🍷 Alcohol Interaction
Alcohol should be avoided while taking this medicine because it can increase the risk of liver toxicity and may cause a disulfiram-like reaction with symptoms such as flushing, nausea, and headache.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Hypersensitivity to ketoconazole or other azole antifungals","Acute or chronic liver disease","Concomitant use with cisapride, terfenadine, astemizole, or other QT-prolonging drugs","Concomitant use with certain benzodiazepines (midazolam, triazolam)","Concomitant use with HMG-CoA reductase inhibitors (statins) metabolized by CYP3A4","Pregnancy (especially first trimester) unless benefit outweighs risk","Lactation (unless benefit outweighs risk)"]
⚠️ Warnings & Precautions
["Serious liver toxicity can occur; monitor liver function closely.","May cause adrenal insufficiency; monitor if prolonged use.","May cause QT prolongation; use with caution in patients with cardiac disease.","May cause dizziness; avoid driving or operating machinery until effects are known.","Avoid alcohol during treatment.","May interact with many drugs; review all medications before starting.","Do not use for minor fungal infections like athlete's foot or vaginal yeast infections.","Use with caution in elderly patients; they may be more susceptible to side effects.","Not recommended for children unless specifically indicated and monitored."]
🤱 Lactation Safety
Ketoconazole is excreted in human breast milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
💊 Overdose Management
In case of overdose, provide supportive and symptomatic treatment. There is no specific antidote. Gastric lavage may be considered if ingestion is recent. Monitor liver function and vital signs. Contact a poison control center or emergency department immediately.
⏰ Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.
Additional Safety Advice
This medicine should only be taken under strict medical supervision. Regular liver function tests are essential before and during treatment. Avoid alcohol as it may increase the risk of liver damage. Do not take this medicine with antacids, acid reducers, or certain other medications without consulting your doctor. Inform your doctor if you have any liver, kidney, or heart conditions. Do not share this medicine with others. If you experience symptoms like severe fatigue, nausea, vomiting, abdominal pain, or yellowing of the eyes or skin, stop the medicine and contact your doctor immediately. This medicine may cause dizziness; avoid driving or operating machinery until you know how it affects you.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients may be more susceptible to the side effects of this medicine, especially liver toxicity and adrenal insufficiency. Dose selection should be cautious, and liver function should be monitored closely.
🤰 Pregnancy Planning (TTC)
This medicine should be avoided during pregnancy, especially in the first trimester, unless the potential benefit justifies the risk. If you are planning pregnancy, consult your doctor to discuss alternative treatments. Effective contraception should be used during treatment.
🏥 Post-Surgery Considerations
This medicine may interact with anesthetics and other medications used during surgery. Inform your surgeon and anesthesiologist that you are taking this medicine. It may need to be temporarily stopped before surgery.
🦷 Dental Procedures
Inform your dentist that you are taking this medicine. It may interact with medications used in dental procedures, and you may need to take precautions due to the risk of bleeding or infection.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
This medicine may cause dizziness or fatigue. Avoid strenuous exercise or activities requiring alertness until you know how it affects you.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine may cause dizziness or fatigue, which can affect your ability to drive or operate machinery. Avoid these activities until you know how the medicine affects you. It may also require frequent medical visits for monitoring, which could impact your work schedule.
🛑 When to Stop This Medicine
Do not stop taking this medicine without consulting your doctor. If you experience serious side effects such as liver problems or severe allergic reactions, stop the medicine and seek immediate medical attention. Your doctor will decide if and when to stop treatment based on your response and monitoring results.
📅 Long-Term Use Effects
Long-term use of this medicine may increase the risk of liver toxicity, adrenal insufficiency, and hormonal effects such as gynecomastia and decreased libido. Regular monitoring of liver function and clinical assessment is required. The risk of side effects increases with higher doses and longer duration of therapy.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Fluconazole, itraconazole, or voriconazole may be alternatives depending on the infection.
Evidence: Well-establishedManagement of symptoms and complications may complement antifungal therapy.
Evidence: Well-established💉 Vaccination Considerations
💉 If You're Getting Vaccinated
No specific vaccine interactions are established. However, live vaccines should be avoided during treatment with immunosuppressive doses of ketoconazole. Consult your doctor before receiving any vaccinations.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C)
❌ DON'T
Do not refrigerate unless specified
✅ DO
Keep in original container
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight
❌ DON'T
Do not store in bathroom cabinet
✈️ Traveling with This Medicine
When traveling, carry this medicine in its original packaging with a copy of your prescription. Keep it in your carry-on luggage to avoid loss. Store at room temperature and protect from extreme heat or cold. If crossing time zones, continue taking your dose at the same interval as prescribed; consult your doctor for specific advice. Check customs regulations for carrying prescription medicines.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: Improvement may be seen within 1-2 weeks, but complete treatment may take several weeks to months depending on the infection.
A: Yes, take it with food to improve absorption and reduce stomach upset.
A: Serious side effects include liver damage, adrenal insufficiency, and severe skin reactions. Report any unusual symptoms to your doctor immediately.
🤔 Common Patient Concerns
🔄 Substitutes for ketomax 400mg tablet
View AllAlternative brands with exact same active ingredient:
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: Ketoconazole is safe for treating any fungal infection.
Fact: Ketoconazole is reserved for serious systemic fungal infections due to its potential for liver toxicity. It is not recommended for minor fungal infections like athlete's foot or vaginal yeast infections. - Myth: You can stop taking ketoconazole once you feel better.
Fact: You must complete the full course as prescribed by your doctor to ensure the infection is fully treated and to prevent recurrence. - Myth: Ketoconazole has no serious side effects.
Fact: Ketoconazole can cause serious liver injury and has many drug interactions. Regular monitoring is required.
🔄 Alternative Options
Generic Alternatives
- Ketoconazole 400mg tablet
Brand Alternatives
- Ketomax 400mg tablet