Drug interactions
Ciclesonide + Ketoconazole
Severity: Moderate
Ciclesonide 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 strongly inhibits CYP3A4 and can raise exposure to the active metabolite of inhaled ciclesonide. This may increase systemic corticosteroid effects such as adrenal suppression, particularly with prolonged co-use.
What this interaction means in plain words
Ciclesonide 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.
Ciclesonide belongs to Respiratory; Ketoconazole belongs to Anti Fungals.
Why it happens
Inhibition of CYP3A4-mediated metabolism of ciclesonide and its active metabolite increases systemic exposure.
What to do
Monitor for signs of systemic corticosteroid excess such as Cushingoid features and adrenal suppression during prolonged co-use. Consider a lower ciclesonide dose or an alternative inhaled steroid if long-term azole therapy is required.
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 Ciclesonide
- Ciclesonide + Ritonavir Major
- Apalutamide + Ciclesonide Moderate
- Atazanavir + Ciclesonide Moderate
- Ceritinib + Ciclesonide Moderate
- Ciclesonide + Clarithromycin Moderate
- Ciclesonide + Cobicistat Moderate
Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Frequently asked questions
Can I take Ciclesonide with Ketoconazole?
MediHelp rates the interaction as moderate. Ciclesonide 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 strongly inhibits CYP3A4 and can raise exposure to the active metabolite of inhaled ciclesonide. This may increase systemic corticosteroid effects such as adrenal suppression, particularly with prolonged co-use.
How serious is the interaction between Ciclesonide 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 for signs of systemic corticosteroid excess such as Cushingoid features and adrenal suppression during prolonged co-use. Consider a lower ciclesonide dose or an alternative inhaled steroid if long-term azole therapy is required.
What other medicines interact with Ciclesonide?
MediHelp also lists interactions of Ciclesonide with, for example, Ritonavir, Apalutamide, Atazanavir. The full list is on the Ciclesonide page.
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