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Ketoconazole cream - How is it working for you?
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zthompson
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Location: West Bloomfield, Michigan USA
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 Posted: Sat Mar 26th, 2005 13:05

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Hello All,

I have a few questions regarding the use of Ketoconozole 2% Cream...I started using the cream about two days ago. I cover my face, hands and other exposed areas. It leaves no residue, no odor and generally I cannot even tell that I have on after a few minutes. Doc will be monitoring liver function each month just to be safe since it is an anti-fungal.

I have to travel outside often for business, so this cream is a big help I think.

My questions:

How was it discovered that it prevents the vitamin D from penetrating the skin?Is there some data that I can read to try to understand?

How effective is it truly? Can I use it daily on exposed areas and then be out in the sun as required? How often should it be reapplied?

I am not trying to beat the sun exposure minimumization required to be successful on the MP, but I seek any and all options to help.

Thanks,

Zach



____________________
Pulm. Sarc. 1994, 3/7/05--1,25D-51, 25D-16, NOIRs, Hidalgos, K2, Benicar-40mg Q6h, Mino 100mg Q48h,Acidophilus Q24h,Reducing Wheat& Sugar
12/06/06--1,25D-21, 25D-6.0
Frans
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 Posted: Sat Mar 26th, 2005 13:41

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Hi Zach,

Perhaps this helps:

http://jcem.endojournals.org/cgi/content/abstract/66/5/934

I did this google search:

http://www.google.nl/search?hl=nl&q=Ketoconazole+1,25&spell=1

just click the link.

Just helping you along a bit.

Hope it helps,

Sincerely, Frans



____________________
Burn-out/nervous breakdown Jan01 125D 48 25D8.48 Ph1Nov06 ModPh2Jan07 Ph2Apr08 Cipramil Seroquel NoIRs lite exp r/t work cover up 25D3.9(Oct07)
DaveW
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 Posted: Sat Mar 26th, 2005 13:48

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Hello,

Is the use of this K cream recognized and recommended by the MP?

If yes, how and when can/should it be used?

Any precautions or down-sides?

Regards,

- DaveW



____________________
MP Aug14/04,Pre-MP D=19.6,1,25D=37 ratio 1.89 P2>12/27/04.Back to P1 fall/05.Back to P2 05/06. 21 yrs neuro-lyme not dx til 11/05. OlmesTR 40 mg/7hrs. Major: Weakness,IBS-C,pain,bad sleep,anxiety,depression,cognitive focus,memory,CMV,epilepsy & osteo
Belinda
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 Posted: Sat Mar 26th, 2005 18:25

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Zach,

Ketoconazole cream stops the synthesis of 1,25-D within the cells of the skin. http://tinyurl.com/727bb This report, which explains that skin cells can produce 1,25-D in response to sunlight, without the help of any other organs, also explains that 2% ketoconazole cream stops this synthesis. The cream suppresed 1,25-D (in the experiment) when applied immediately after light exposure.

We are still experimenting with the use of 2% ketoconazole cream to stop skin synthesis of 1,25-D. We know it works, but since this is an off-label use of the cream, this is still new. Keep in mind that the report that 1,25-D is produced autonomously by skin cells was published only 2 years ago. This was BIG NEWS and it still hasn't been digested by lots of physicians yet.

The 2% ketoconazole cream is a prescription medication, and there could always be an unexpected reaction to it. We recommend that skin be covered, and the cream be used only in areas that cannot be covered, and *when light exposure is unavoidable*.

There was a study of the safety of several topical creams, including ketoconazole: http://tinyurl.com/6edbb It said, "Both calcipotriene and ketoconazole were moderate irritants and possible sensitization reactions were also associated with ketoconazole. CONCLUSION: Although every topically applied chemical has the potential to cause an adverse response in some individuals, the data obtained in this study for eight commercially available prescription dermatologic products indicate that most are quite safe and have very low risks of clinically significant irritation or sensitization."

I use it once in the morning.

Belinda

Last edited on Sat Mar 26th, 2005 18:51 by Belinda

Belinda
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 Posted: Sat Mar 26th, 2005 18:45

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Franz,

The article you shared is about ketoconazole, not in a cream, but in an oral application. It gets across the idea, though.

It's been known for close to 20 years that oral ketoconazole will induce reduction of serum 1,25-D, but this antifungal, when taken by mouth, has the potential to cause liver damage. Oral Ketoconazole can also interact with other medications, potentially resulting in serious problems. http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682816.html

Belinda

Aussie Barb
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 Posted: Sat Mar 26th, 2005 18:59

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Dave

Belinda also says: that the K cream is too expensive to use all over, and there's always a possibility it could irritate or be absorbed if used too heavily.

Barb ...



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Barb: Dx Inflammatory Disease Endocrine Imbalance 2003| 24+ years not Dx| ABCofMP
zthompson
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 Posted: Sat Mar 26th, 2005 19:21

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Thanks Belinda and Barb,

I think my best approach is to cover my face,neck and hands daily with the K2 cream. It does sound promising from the study.

Zach



____________________
Pulm. Sarc. 1994, 3/7/05--1,25D-51, 25D-16, NOIRs, Hidalgos, K2, Benicar-40mg Q6h, Mino 100mg Q48h,Acidophilus Q24h,Reducing Wheat& Sugar
12/06/06--1,25D-21, 25D-6.0
Meg Mangin R.N.
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 Posted: Sat Mar 26th, 2005 19:29

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Zach,

It's pretty easy to cover your hands with gloves even in the summer. Here is a link to sun-protective gloves by Solumbra. But any dark, heavier glove will do. There are also hats that extend down the back of the neck to provide better sun protection in that often exposed area. Since we don't know how effective the K-cream is or for how long, covering up with proper clothing is still your best bet.

Best,

Meg



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Nothing contained in this site is or should be considered, or used as a substitute for, medical advice, diagnosis or treatment by your physician.
DaveW
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 Posted: Sun Mar 27th, 2005 02:38

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Belinda,

You said you used it once in the morning. May I please ask where you use it, and what difference you percieve it to make?

Thanks,

Regards,

- DaveW



____________________
MP Aug14/04,Pre-MP D=19.6,1,25D=37 ratio 1.89 P2>12/27/04.Back to P1 fall/05.Back to P2 05/06. 21 yrs neuro-lyme not dx til 11/05. OlmesTR 40 mg/7hrs. Major: Weakness,IBS-C,pain,bad sleep,anxiety,depression,cognitive focus,memory,CMV,epilepsy & osteo
Belinda
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 Posted: Sun Mar 27th, 2005 05:39

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Dave W,

I use the 2% Ketoconazole cream in the morning to my face and neck when I know I will be exposed to sun and will not be protected. For instance, I used the cream traveling to and during the Chicago conference. I can tolerate some skin exposure, but if my face, hands and neck are all exposed for several hours, I can get a red lesion on my neck or face. These lesions resolve within a day or two, so they are not nearly comparable to skin problems I used to have.

I usually wear scarves or bandanas, hat and gloves on my walk, so my neck, face and hands are protected. I use the K cream when I am in situations where I do not wear all this protection.

Belinda

Last edited on Sun Mar 27th, 2005 05:40 by Belinda

zackone
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 Posted: Sun Mar 27th, 2005 21:33

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Hi all!!  I tried the k-creme the latter part of last week while at work, and used it 4 x day (6, 9, 12, 3).  I am unsure if it helped with sun sickness, but I see you use just once a day.  If you were to get on and off sun exposure throughout the day, is the one time a day still suffice?  My chin feels a little irritated, which could be the k-creme combined with shaving, or actually a herx (I guess), but I do not want to overuse!!

Thanks for your help!!  Fred



____________________
Sarcoidosis/lungs 125D55 Ph1Mar05 Ph3Feb06 Travatan eye drops NoIRs mod daily sun exp. covered (experimenting) 25D9 (Oct07) 25D7 (Apr08) 1,25D21(April08)
Lee
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 Posted: Sun Mar 27th, 2005 21:42

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Here is a little something I just wrote earlier about the K Cream......after a near disaster visit to the beauty shop and shopping where I encountered way too much light and chemicals from hair coloring.....

Oh yeah.....before the shopping and beauty adventures I did use my Ketoconazole Cream on my face and hands.....and then later in the evening after my shower I really used liberal amounts around my hairline and on the sore hot spots!!!  Well folks....that skin is like brand NEW now....that cream is simple GREAT!!!  It looks like I had something special "done" to my forehead".....gals ya know what I mean?!   Lee feeling almost "purdy".....:dude:




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D ratio-2.13 Ph1-2/05 Benicar| 4/05 PH2| 06 Ph3| 2008 D25-9.7 silymarin/sunlight w/noirs
Meg Mangin R.N.
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 Posted: Mon Mar 28th, 2005 03:52

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Fred,

We have no data on how long Ketoconazole cream lasts after application or how much of it is absorbed systemically. That is why we recommend that you use it sparingly and rely on avoidance of sunlight primarily.

Best,

Meg



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Nothing contained in this site is or should be considered, or used as a substitute for, medical advice, diagnosis or treatment by your physician.
jcwat101
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 Posted: Fri Apr 1st, 2005 17:46

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Just to add to the information here on the ketoconazole cream, here is the following:
Quoting from the 2004 Edition of the Physician's Desk Reference (aka PDR, the drug "Bible" for doctors and pharmacists) on page 1757:

<<Clinical Pharmacology

When Nizoral (ketoconazole) 2% Cream was applied dermally to intact or abraded skin of Beagle dogs for 28 consecutive days at a dose of 80 mg, there were no detectable plasma levels using an assay method having a lower detection limit of 2 ng/ml.

After a single topical application to the chest, back and arms of normal volunteers, systemic absorption of ketoconazole was not detected at the 5 ng/ml level in blood over a 72-hour period.

Two dermal irritancy studies, a human sensitization test, a phototoxicity study and a photoallergy study conducted in 38 male and 62 female volunteers showed no contact sensitization of the delayed hypersensitivity type, no irritation, no phototoxicity and no photoallergenic potential due to Nizoral (ketoconazole) 2% Cream.>>

One can contrast this with the amount one gets when one takes a single 200 mg oral dose, where the peak plasma levels reach 3.5 micrograms/ml (also, see PDR). According to my reference book, nanograms are 1,000 fold smaller. So, 3.5 micrograms/ml is identical to 3,500 ng/ml. So, one can see that the dose that reaches the bloodstream is infinitesimal for the cream (less than 2 to 5 ng/ml) compared to an oral dose.

Joyce Waterhouse, Ph.D.



____________________
20 yrs with CFS/FM/Lyme/IBS, food sensitivities; 1,25D/25D 8/04:64/11 1/05:22/6 9/05:1,25D=12 10/06:22/8, 4/07:25/<4 chewed Ben. 40mg q8h; Mod. P2: 2/23/05, P2: 4/06; P3: 1/1/07
zackone
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 Posted: Fri Apr 1st, 2005 21:41

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Joyce, Thanks so much!  I was honestly concerned as I was using it twice a day!!  This does make me breath a little easier!!

Thanks again!!  Fred



____________________
Sarcoidosis/lungs 125D55 Ph1Mar05 Ph3Feb06 Travatan eye drops NoIRs mod daily sun exp. covered (experimenting) 25D9 (Oct07) 25D7 (Apr08) 1,25D21(April08)
TickTock
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 Posted: Mon Apr 4th, 2005 22:09

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Hi Meg,

Do all the products on the Solumbra sight coverup enough of the sun.  Most of the products are white and some have a mesh area for breathing.  Are they still completely covering the sun??

TT



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Dx: Lyme Disease,Bartonella 25yrs/ 9/26 25D=9 1.25D=79 4/05 25D=8 1,25D=44/ 10mg Lexapro,.5 Xanax / 9/04 start MP/ 5/21 Benicar40mgQ6H Q
8/7/05 Phase 2 10/24 Benicar 20mgQ6H
Aussie Barb
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 Posted: Mon Apr 4th, 2005 22:12

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TT

see this thread re Solumbra Solumbra Accessories

Barb ...



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Aussie Barb
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 Posted: Thu Apr 14th, 2005 16:08

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Chris wrote: @ phase 2 reportI found out two things yesterday.

1) ketoconazole works.
2) When you forget to use it, any exposed skin
is too much.

On the way to work, I was about 10 miles down the
road and I remember I hadn't applied the ketoconazole
cream. I did have gloves, and a hat with drapes
that leaves only my chin exposed. I tried to hold
something over my chin to shade it on the rest
of the drive, but it wasn't sufficient. The shakes
started about noon, and kept up periodically until
3 AM.
Chris: sarcoid diagnosed 1991, probably started 1983
D25/1,25: Mar04 17/80, Sep04 12/50, Nov04 8/23, Jan05 9/39
40x4 Benicar +Q, 100mino/48h/phase2 Dec/24/2004
tinnitus/depression/mental-fog/IBS/
carpal-tunnel/fatigue



____________________
Barb: Dx Inflammatory Disease Endocrine Imbalance 2003| 24+ years not Dx| ABCofMP
zthompson
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 Posted: Tue May 10th, 2005 23:41

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Hello All,

I am wondering what those using Ketoconozole 2% cream think about its effectiveness and how long each application lasts?

Since no clear data exists, I was thinking that it may be helpful for those who have had good/bad experiences, post their opinions.

I apply to my face, neck and hands each morning and then again if I have to go out for any length. I have not had any apparent problems and feel that it is working, since I do seem to be having some herx. I do cover-up outside whenever possible and cave-dwell for most of the day. I can feel the K2 cream on my skin hours after application...Not sure if it is still working though.

If my experience is true, this is making work/business possible for me (although my job keeps me indoors most of the day). I would feel better knowing others feel the same or ???

Perhaps if enough people post, this could serve as an unscientific test.

Thanks,

Zach



____________________
Pulm. Sarc. 1994, 3/7/05--1,25D-51, 25D-16, NOIRs, Hidalgos, K2, Benicar-40mg Q6h, Mino 100mg Q48h,Acidophilus Q24h,Reducing Wheat& Sugar
12/06/06--1,25D-21, 25D-6.0
KFaucher
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 Posted: Thu May 12th, 2005 22:48

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I have just returned from a fishing trip, 3 days in a canoe under the sun, and I have been thinking about this very subject.

I believe that k-cream has a limited usefulness. It seems to work well for low level or limited time exposure. I have very good response when using it for driving, or when out in shady or low light conditions. When in direct sun or highly reflected sun (from water or snow) I believe it's usefullness wears out quickly. For a full day out in the sun, I don't think it has any affect at all.

But that could just be a delusion of my sunburn fevered brain.

Ken



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