Drug interactions
Bortezomib + Ketoconazole
Severity: Moderate
Bortezomib 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 inhibits CYP3A4 and raises bortezomib exposure. This may increase toxicities such as peripheral neuropathy, thrombocytopenia, gastrointestinal effects and hypotension.
What this interaction means in plain words
Bortezomib 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.
Bortezomib belongs to Oncology; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits CYP3A4, a major pathway of bortezomib metabolism, increasing exposure.
What to do
Monitor closely for bortezomib toxicity, particularly neuropathy and cytopenias, and reduce the dose or interrupt therapy if toxicity appears.
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 Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Other interactions of Bortezomib
- Apalutamide + Bortezomib Major
- Bortezomib + Carbamazepine Major
- Bortezomib + Etrasimod Major
- Bortezomib + Fosphenytoin Major
- Bortezomib + Idelalisib Major
- Bortezomib + Lonafarnib Major
Frequently asked questions
Can I take Bortezomib with Ketoconazole?
MediHelp rates the interaction as moderate. Bortezomib 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 inhibits CYP3A4 and raises bortezomib exposure. This may increase toxicities such as peripheral neuropathy, thrombocytopenia, gastrointestinal effects and hypotension.
How serious is the interaction between Bortezomib 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 closely for bortezomib toxicity, particularly neuropathy and cytopenias, and reduce the dose or interrupt therapy if toxicity appears.
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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