Drug interactions
Brigatinib + Ketoconazole
Severity: Major
Brigatinib and Ketoconazole: major interaction.
Last updated Sources: US FDA label
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 increases brigatinib exposure, which may increase pulmonary toxicity, hypertension, bradycardia and pancreatic enzyme elevations.
What this interaction means in plain words
Brigatinib 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.
Brigatinib belongs to Oncology; Ketoconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A inhibition decreases brigatinib metabolism.
What to do
Avoid the combination; if unavoidable, reduce the brigatinib dose by about half and monitor for respiratory symptoms and heart rate. Resume the prior dose after the inhibitor is stopped.
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 Brigatinib
Frequently asked questions
Can I take Brigatinib with Ketoconazole?
MediHelp rates the interaction as major. Brigatinib 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 increases brigatinib exposure, which may increase pulmonary toxicity, hypertension, bradycardia and pancreatic enzyme elevations.
How serious is the interaction between Brigatinib 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; if unavoidable, reduce the brigatinib dose by about half and monitor for respiratory symptoms and heart rate. Resume the prior dose after the inhibitor is stopped.
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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