Drug interactions
Amiodarone + Ketoconazole
Severity: Major
Amiodarone and Ketoconazole: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs prolong the QT interval, and ketoconazole may also raise amiodarone concentrations. Together they increase the risk of torsades de pointes and other serious ventricular arrhythmias.
What this interaction means in plain words
Amiodarone and Ketoconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Ketoconazole belongs to Anti Fungals.
Why it happens
Additive QT prolongation combined with CYP3A4 inhibition by ketoconazole reducing amiodarone metabolism.
What to do
Avoid the combination where possible and use a non-QT-prolonging antifungal. If unavoidable, obtain a baseline ECG, correct potassium and magnesium, and monitor QTc regularly.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Ketoconazole?
MediHelp rates the interaction as major. Amiodarone and Ketoconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs prolong the QT interval, and ketoconazole may also raise amiodarone concentrations. Together they increase the risk of torsades de pointes and other serious ventricular arrhythmias.
How serious is the interaction between Amiodarone and Ketoconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and use a non-QT-prolonging antifungal. If unavoidable, obtain a baseline ECG, correct potassium and magnesium, and monitor QTc regularly.
What other medicines interact with Ketoconazole?
MediHelp also lists interactions of Ketoconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Ketoconazole page.
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