Drug interactions
Cabozantinib + Ketoconazole
Severity: Major
Cabozantinib and Ketoconazole: major 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 increases cabozantinib exposure, which may increase hypertension, diarrhea, hand-foot syndrome and hemorrhage risk.
What this interaction means in plain words
Cabozantinib 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.
Cabozantinib belongs to Oncology; Ketoconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 inhibition reduces cabozantinib clearance.
What to do
Avoid if possible; otherwise reduce the cabozantinib dose per labeling and monitor for toxicity. Restore the prior dose 2 to 3 days after stopping the inhibitor.
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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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 Cabozantinib
Frequently asked questions
Can I take Cabozantinib with Ketoconazole?
MediHelp rates the interaction as major. Cabozantinib 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 cabozantinib exposure, which may increase hypertension, diarrhea, hand-foot syndrome and hemorrhage risk.
How serious is the interaction between Cabozantinib 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 if possible; otherwise reduce the cabozantinib dose per labeling and monitor for toxicity. Restore the prior dose 2 to 3 days after stopping the inhibitor.
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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