Drug interactions
Amlodipine-atorvastatin + Ketoconazole
Severity: Major
Amlodipine-atorvastatin 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
Ketoconazole is a strong CYP3A4 inhibitor and can substantially raise amlodipine and atorvastatin levels. This increases the risk of hypotension and edema, and of myopathy or rhabdomyolysis from atorvastatin.
What this interaction means in plain words
Amlodipine-atorvastatin 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.
Amlodipine-atorvastatin belongs to Cardiovascular; Ketoconazole belongs to Anti Fungals.
Why it happens
Strong inhibition of CYP3A4 by ketoconazole reduces the first-pass and systemic metabolism of both amlodipine and atorvastatin.
What to do
Avoid the combination where possible, or temporarily stop the statin component and use separate agents during ketoconazole therapy. Monitor blood pressure and for muscle symptoms, checking creatine kinase if they occur.
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 Amlodipine-atorvastatin
Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Frequently asked questions
Can I take Amlodipine-atorvastatin with Ketoconazole?
MediHelp rates the interaction as major. Amlodipine-atorvastatin 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. Ketoconazole is a strong CYP3A4 inhibitor and can substantially raise amlodipine and atorvastatin levels. This increases the risk of hypotension and edema, and of myopathy or rhabdomyolysis from atorvastatin.
How serious is the interaction between Amlodipine-atorvastatin 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, or temporarily stop the statin component and use separate agents during ketoconazole therapy. Monitor blood pressure and for muscle symptoms, checking creatine kinase if they occur.
What other medicines interact with Amlodipine-atorvastatin?
MediHelp also lists interactions of Amlodipine-atorvastatin with, for example, Amifostine, Apalutamide, Atazanavir. The full list is on the Amlodipine-atorvastatin page.
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