Drug interactions
Deflazacort + Ketoconazole
Severity: Major
Deflazacort 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 markedly increases exposure to the active metabolite of deflazacort, raising the risk of corticosteroid adverse effects including Cushingoid features, hyperglycemia, infection and adrenal suppression.
What this interaction means in plain words
Deflazacort 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.
Deflazacort belongs to Miscellaneous; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits CYP3A4, which metabolizes deflazacort's active metabolite, and may also inhibit P-glycoprotein.
What to do
Reduce the deflazacort dose to about one-third of the recommended dose while taking a strong CYP3A4 inhibitor, per labeling. Monitor for corticosteroid toxicity and potassium levels.
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 Deflazacort
- Adenovirus types 4 and 7 live + Deflazacort Contraindicated
- Bcg vaccine live + Deflazacort Contraindicated
- Deflazacort + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Deflazacort + Measles mumps and rubella vaccine Contraindicated
- Deflazacort + Measles mumps and rubella vaccine live Contraindicated
- Deflazacort + Measles mumps rubella and varicella vaccine live Contraindicated
Frequently asked questions
Can I take Deflazacort with Ketoconazole?
MediHelp rates the interaction as major. Deflazacort 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 increases exposure to the active metabolite of deflazacort, raising the risk of corticosteroid adverse effects including Cushingoid features, hyperglycemia, infection and adrenal suppression.
How serious is the interaction between Deflazacort 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 deflazacort dose to about one-third of the recommended dose while taking a strong CYP3A4 inhibitor, per labeling. Monitor for corticosteroid toxicity and potassium levels.
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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