Use of ketoconazole for hypercalciuria

July 23, 2008

Some types of hypercalciuria are vitamin D-dependent and, in those cases, drugs that suppress vitamin D can be useful in the diagnosis of the disease and in its treatment, according to experts at the Lorain Kidney Stone Research Center at the Medical College of Ohio. One such drug is ketoconazole, which is normally used as a broad-spectrum anti-fungal drug. However, since it interferes with the synthesis of vitamin D-3 by inhibiting a particular enzyme system, it has specific value in this type of hypercalciuria.

According to researchers, the long-term use of ketoconazole for hypercalciuria has to be balanced against its cost, adverse effects, and potential toxicity, especially on the liver, which requires careful monitoring. This must be carefully discussed with your physician, particularly since ketoconazole would not be a first-line choice.

Ketoconazole has documented hypersensitivity. It should not be used by those who have fungal meningitis, nor by those who are using the drugs terfenadine, astemizole, or cisapride. Caution should be used if you are taking certain other drugs because it may increase or decrease their effects or their toxicity, another subject to be discussed with your physician and which may require adjustment of other prescriptions.

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