Drug interactions
Daridorexant + Ketoconazole
Severity: Major
Daridorexant 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 markedly raises daridorexant exposure, increasing the risk of excessive sedation, next-day somnolence and impaired driving. Labeling advises against combining daridorexant with strong CYP3A4 inhibitors.
What this interaction means in plain words
Daridorexant 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.
Daridorexant belongs to Central Nervous System; Ketoconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 inhibition by ketoconazole decreases the clearance of daridorexant.
What to do
Avoid the combination and choose a different hypnotic or antifungal. If unavoidable, use the lowest daridorexant dose and monitor for daytime sedation.
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 Daridorexant
Frequently asked questions
Can I take Daridorexant with Ketoconazole?
MediHelp rates the interaction as major. Daridorexant 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 markedly raises daridorexant exposure, increasing the risk of excessive sedation, next-day somnolence and impaired driving. Labeling advises against combining daridorexant with strong CYP3A4 inhibitors.
How serious is the interaction between Daridorexant 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 and choose a different hypnotic or antifungal. If unavoidable, use the lowest daridorexant dose and monitor for daytime sedation.
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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