Drug interactions
Amlodipine-hydrochlorothiazide-valsartan + Ketoconazole
Severity: Moderate
Amlodipine-hydrochlorothiazide-valsartan and Ketoconazole: moderate 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 strongly inhibits CYP3A4 and can raise amlodipine concentrations, increasing hypotension and peripheral edema. Valsartan exposure may also rise modestly through inhibition of hepatic uptake transporters.
What this interaction means in plain words
Amlodipine-hydrochlorothiazide-valsartan and Ketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amlodipine-hydrochlorothiazide-valsartan belongs to Cardiovascular; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits CYP3A4-mediated amlodipine metabolism and may inhibit OATP1B1-mediated hepatic uptake of valsartan.
What to do
Monitor blood pressure and for edema or dizziness when ketoconazole is started, and reduce the amlodipine dose if hypotension occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Amlodipine-hydrochlorothiazide-valsartan
- Aliskiren + Amlodipine-hydrochlorothiazide-valsartan Contraindicated
- Amlodipine-hydrochlorothiazide-valsartan + Dofetilide Contraindicated
- Amlodipine-hydrochlorothiazide-valsartan + Sparsentan Contraindicated
- Aceclofenac + Amlodipine-hydrochlorothiazide-valsartan Major
- Aldesleukin + Amlodipine-hydrochlorothiazide-valsartan Major
- Amifostine + Amlodipine-hydrochlorothiazide-valsartan Major
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-hydrochlorothiazide-valsartan with Ketoconazole?
MediHelp rates the interaction as moderate. Amlodipine-hydrochlorothiazide-valsartan and Ketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ketoconazole strongly inhibits CYP3A4 and can raise amlodipine concentrations, increasing hypotension and peripheral edema. Valsartan exposure may also rise modestly through inhibition of hepatic uptake transporters.
How serious is the interaction between Amlodipine-hydrochlorothiazide-valsartan and Ketoconazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure and for edema or dizziness when ketoconazole is started, and reduce the amlodipine dose if hypotension occurs.
What other medicines interact with Amlodipine-hydrochlorothiazide-valsartan?
MediHelp also lists interactions of Amlodipine-hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Amlodipine-hydrochlorothiazide-valsartan page.
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