Drug interactions
Bosutinib + Ketoconazole
Severity: Major
Bosutinib and Ketoconazole: major interaction.
Last updated Sources: UK SmPC
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 greatly increases bosutinib exposure, raising the risk of hepatotoxicity, diarrhea and myelosuppression.
What this interaction means in plain words
Bosutinib 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.
Bosutinib belongs to Oncology; Ketoconazole belongs to Anti Fungals.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein reduces bosutinib clearance.
What to do
Avoid combination and select an alternative antifungal. If unavoidable, monitor liver tests, blood counts and GI toxicity closely.
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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References
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 Bosutinib
- Amiodarone + Bosutinib Major
- Apalutamide + Bosutinib Major
- Aprepitant + Bosutinib Major
- Bosentan + Bosutinib Major
- Bosutinib + Carbamazepine Major
- Bosutinib + Chlorpromazine Major
Frequently asked questions
Can I take Bosutinib with Ketoconazole?
MediHelp rates the interaction as major. Bosutinib 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 greatly increases bosutinib exposure, raising the risk of hepatotoxicity, diarrhea and myelosuppression.
How serious is the interaction between Bosutinib 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 combination and select an alternative antifungal. If unavoidable, monitor liver tests, blood counts and GI toxicity closely.
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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