Drug interactions
Darunavir + Ketoconazole
Severity: Major
Darunavir 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 and darunavir (usually boosted with ritonavir or cobicistat) raise each other's concentrations. This increases the risk of adverse effects from both drugs, including hepatotoxicity and QT effects.
What this interaction means in plain words
Darunavir 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.
Darunavir belongs to Anti Virals; Ketoconazole belongs to Anti Fungals.
Why it happens
Both agents are CYP3A4 substrates and inhibitors, giving reciprocal inhibition of metabolism.
What to do
Keep the ketoconazole dose at or below 200 mg daily with boosted darunavir and monitor liver function. Consider an alternative azole where possible.
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 Darunavir
- Alfuzosin + Darunavir Contraindicated
- Avanafil + Darunavir Contraindicated
- Darunavir + Dronedarone Contraindicated
- Darunavir + Eletriptan Contraindicated
- Darunavir + Ergotamine Contraindicated
- Darunavir + Flibanserin Contraindicated
Frequently asked questions
Can I take Darunavir with Ketoconazole?
MediHelp rates the interaction as major. Darunavir 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 and darunavir (usually boosted with ritonavir or cobicistat) raise each other's concentrations. This increases the risk of adverse effects from both drugs, including hepatotoxicity and QT effects.
How serious is the interaction between Darunavir 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: Keep the ketoconazole dose at or below 200 mg daily with boosted darunavir and monitor liver function. Consider an alternative azole where possible.
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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