Drug interactions
Aprepitant + Ketoconazole
Severity: Moderate
Aprepitant 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 is a strong CYP3A4 inhibitor and markedly raises aprepitant exposure. This may increase aprepitant adverse effects.
What this interaction means in plain words
Aprepitant 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.
Aprepitant belongs to Gastrointestinal Tract; Ketoconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 inhibition by ketoconazole reduces aprepitant clearance.
What to do
Avoid if a practical alternative exists, or monitor for aprepitant adverse effects such as fatigue, dizziness and gastrointestinal upset.
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 Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat 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 Aprepitant with Ketoconazole?
MediHelp rates the interaction as moderate. Aprepitant 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 is a strong CYP3A4 inhibitor and markedly raises aprepitant exposure. This may increase aprepitant adverse effects.
How serious is the interaction between Aprepitant 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: Avoid if a practical alternative exists, or monitor for aprepitant adverse effects such as fatigue, dizziness and gastrointestinal upset.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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