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Ketoconazole is an azole antifungal medication used to treat serious fungal infections such as candidiasis (thrush), blastomycosis (Gilchrist's disease), coccidioidomycosis (Valley fever), histoplasmosis (Darling's disease), chromoblastomycosis (chromomycosis), and paracoccidioidomycosis. It works by inhibiting the synthesis of ergosterol in fungal cell membranes through inhibition of the enzyme lanosterol 14-alpha demethylase, leading to increased membrane permeability and growth arrest of fungi. Ketoconazole also has antiandrogen and antiglucocorticoid activity at high doses due to inhibition of steroidogenic enzymes such as 17α-hydroxylase and 17,20-lyase[1][4][5].
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