We have studied the pharmacokinetics of the anti-mycotic ketoconazole in seven patients who took it for 1-6 months at a dose of 200 mg daily. The mean elimination half-life of the drug was 3.3 h, and although the ketoconazole was given only once daily, a satisfactory clinical response was obtained in all seven individuals. Only a small fraction of the absorbed drug (mean 0.22%) was excreted unchanged in the urine, suggesting almost complete metabolism. Our results support the concept that anti-mycotic activity in the tissues continues after the plasma drug concentration has fallen below a critical level. Our results also support the concept of a change in pharmacokinetics with chronic dosing.
Contact allergic sensitivity may follow the use of chlorocresol incorporated as a preservative into both betamethasone cream and aqueous cream, which are commonly prescribed as a mixture in South Australia. In several cases, although the clinical courses indicated sensitivity to chlorocresol, patch test reactions to this chemical were negative. In these cases positive patch test reactions to chloroxylenol, a chemical closely related to chlorocresol, confirmed the diagnoses.
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