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NAFDAC have banned this DRUG..... Even when consume in the right dose, can cause HEPATOTOXICITY and may require LIVER TRANSPLANT.
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Yes. Ketoconazole can cause liver injury, and in some cases it can be serious.
The risk is particularly important with oral ketoconazole tablets. Liver injury is much less of a concern with ketoconazole creams or shampoos, because very little is absorbed into the bloodstream.

Possible warning signs of liver injury include:
Yellow eyes or skin
Dark urine
Pale stools
Severe or persistent nausea
Loss of appetite
Unusual tiredness
Pain in the upper-right abdomen

If you're taking oral ketoconazole, it should generally only be used under medical supervision, with attention to liver function and drug interactions.

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The important thing is to distinguish between oral ketoconazole and ketoconazole cream or shampoo. The liver concern is much greater with the tablets because they enter the bloodstream.

The distinction between tablets and topical ketoconazole should be emphasized. Someone reading “ketoconazole damages the liver” might become unnecessarily afraid of using a prescribed cream.

Another thing is drug interaction. Someone already taking other medicines should tell their doctor or pharmacist before using oral ketoconazole..

The warning signs mentioned here are important. Yellow eyes, dark urine and unusual tiredness should not be ignored when someone is taking a medicine that can affect the liver.
I have always believed that “antifungal” doesn't automatically mean safe for everyone. Every medicine has benefits and risks, depending on the dose and how long it is used.

This is why people shouldn't just take antifungal tablets for weeks without medical supervision. A drug can be useful and still have serious side effects.

This is a good reminder not to self-medicate. If someone has a fungal infection, the right treatment depends on the type and location of the infection.

One thing people should remember is that liver injury isn't always immediately obvious. Someone can feel fine initially, which is why medical supervision matters with higher-risk medicines.

I have seen people take antifungal medication repeatedly whenever they notice itching. That can be risky because itching doesn't automatically mean a fungal infection.