What is the difference between Lamisil and Ketoconazole? 

What is the difference between Lamisil and Ketoconazole?

Lamisil (Terbinafine) and Ketoconazole are both antifungal medications which are used to treat different types of fungal infections and work in different ways (1,2). 

Lamisil (Terbinafine) is available in oral and topical dosage forms and is frequently used to treat onychomycosis. It is also used in children above 4 years of age (1). 

Ketoconazole, on the other hand, is used as a topical antifungal medication. It was also available in oral dosage form once, but because of its hepatotoxic nature, it was removed from the market (2,3). 

Now, it’s only used as antifungal cream and it’s not recommended for children below 16 years of age. Ketoconazole cream is mainly used to manage and treat candidiasis, oral thrush, histoplasmosis, blastomycosis, chromomycosis, etc (2). 

Both of these meds are good at what they do and can be used for some common conditions like Tinea corporis (Ringworm disease). However, they are prescription medications and should only be used with your doctor’s approval (1,2). 

How to choose between Lamisil and Ketoconazole?

Choosing between Lamisil and Ketoconazole depends on the specific condition you are treating and your healthcare provider’s recommendation. 

Your doctor will consider factors such as the type and severity of the fungal infection, your medical history, and any other medications you may be taking. They will then recommend the most suitable option for you.

For localized skin infections or those affecting the scalp, Ketoconazole topical products may be sufficient. However, for more extensive or persistent infections, oral Lamisil might be necessary (1,2).

It’s important to discuss your medical history, any existing health conditions, and any other medications you are taking with your healthcare provider before deciding on one of these treatments. 

How to ensure the proper use of antifungal medications?

To ensure the proper use of antifungal medications, the following steps are essential (4):

  • Take the antifungal medication exactly as instructed by your healthcare provider. Don’t skip doses or take more than recommended.
  • Even if you start feeling better, continue taking the medication for the entire prescribed duration to ensure the infection is completely treated.
  • Some antifungals are best taken with food to improve absorption, while others should be taken on an empty stomach. Follow the specific instructions provided by your doctor.
  • Refrain from consuming alcohol while on antifungal medication, as it may interact with the drug and reduce its effectiveness.
  • For topical antifungal creams, maintain good hygiene and dryness in the affected area to aid in the healing process.
  • Store antifungal medications at the recommended temperature and away from moisture or direct sunlight.
  • Avoid sharing your antifungal medication with others, even if they have similar symptoms. Each person’s condition may be different, and sharing can lead to ineffective treatment.
  • If you experience any unusual or severe side effects while using the antifungal medication, inform your healthcare provider immediately.

It is important to know that each individual is unique and may have different factors affecting their health. 

What works for one may not work for another. This is why you need to ensure the safe and effective treatment to achieve the therapeutic response you’re hoping for. If you’re concerned about anything, please talk to your doctor. 

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Maxfield L, Preuss CV, Bermudez R. Terbinafine. 2023 May 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31424802. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545218


Sinawe H, Casadesus D. Ketoconazole. 2022 Jun 27. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32644647. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559221


Gupta AK, Lyons DC. The Rise and Fall of Oral Ketoconazole. J Cutan Med Surg. 2015 Jul-Aug;19(4):352-7. doi: 10.1177/1203475415574970. Epub 2015 Mar 5. PMID: 25775613. Available from: https://pubmed.ncbi.nlm.nih.gov/25775613/


Norfolk and Norwich University Hospital. National Health Services (NHS). Trust Guideline for the Use of Antifungals in Adults [Internet]. Available from: https://www.nnuh.nhs.uk/publication/download/antifungal-clinical-guideline-ca4006-v3-2/