Drug interactions
Cariprazine + Ketoconazole
Severity: Major
Cariprazine 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 raises exposure to cariprazine and its active metabolites, which have long half-lives. This can increase sedation, akathisia, extrapyramidal symptoms and other dose-related adverse effects.
What this interaction means in plain words
Cariprazine 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.
Cariprazine belongs to Central Nervous System; Ketoconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 inhibition by ketoconazole reduces the metabolic clearance of cariprazine.
What to do
Reduce the cariprazine dose according to labeling when starting a strong CYP3A4 inhibitor, and monitor for adverse effects. Re-evaluate the dose when ketoconazole is stopped, allowing for the long half-life.
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 Cariprazine
Frequently asked questions
Can I take Cariprazine with Ketoconazole?
MediHelp rates the interaction as major. Cariprazine 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 raises exposure to cariprazine and its active metabolites, which have long half-lives. This can increase sedation, akathisia, extrapyramidal symptoms and other dose-related adverse effects.
How serious is the interaction between Cariprazine 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: Reduce the cariprazine dose according to labeling when starting a strong CYP3A4 inhibitor, and monitor for adverse effects. Re-evaluate the dose when ketoconazole is stopped, allowing for the long half-life.
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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