Drug interactions
Clonazepam + Ketoconazole
Severity: Moderate
Clonazepam 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 may modestly increase clonazepam concentrations, with more sedation, psychomotor impairment and possible respiratory depression. The effect is typically moderate in size but matters in the elderly and in patients taking other CNS depressants.
What this interaction means in plain words
Clonazepam 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.
Clonazepam belongs to Central Nervous System; Ketoconazole belongs to Anti Fungals.
Why it happens
Inhibition of CYP3A4-mediated clonazepam metabolism by ketoconazole.
What to do
Monitor for excessive sedation and reduce the clonazepam dose if symptoms occur. Counsel the patient about driving and alcohol.
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 Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Other interactions of Clonazepam
- Calcium / magnesium / potassium / sodium oxybates + Clonazepam Contraindicated
- Clonazepam + Sodium oxybate Contraindicated
- Alfentanil + Clonazepam Major
- Alprazolam + Clonazepam Major
- Amobarbital + Clonazepam Major
- Belladonna and opium + Clonazepam Major
Frequently asked questions
Can I take Clonazepam with Ketoconazole?
MediHelp rates the interaction as moderate. Clonazepam 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 may modestly increase clonazepam concentrations, with more sedation, psychomotor impairment and possible respiratory depression. The effect is typically moderate in size but matters in the elderly and in patients taking other CNS depressants.
How serious is the interaction between Clonazepam 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 excessive sedation and reduce the clonazepam dose if symptoms occur. Counsel the patient about driving and alcohol.
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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