Drug interactions
Dexlansoprazole + Ketoconazole
Severity: Major
Dexlansoprazole 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 requires gastric acid for absorption, so dexlansoprazole can substantially reduce its levels and cause antifungal failure.
What this interaction means in plain words
Dexlansoprazole 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.
Dexlansoprazole belongs to Gastrointestinal Tract; Ketoconazole belongs to Anti Fungals.
Why it happens
Raised gastric pH reduces ketoconazole dissolution and absorption.
What to do
Avoid the combination where possible and consider fluconazole or another alternative. If unavoidable, monitor clinical response.
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 Dexlansoprazole
- Dexlansoprazole + Mavacamten Contraindicated
- Dexlansoprazole + Rilpivirine Contraindicated
- Acalabrutinib + Dexlansoprazole Major
- Atazanavir + Dexlansoprazole Major
- Dacomitinib + Dexlansoprazole Major
- Dasatinib + Dexlansoprazole Major
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 Dexlansoprazole with Ketoconazole?
MediHelp rates the interaction as major. Dexlansoprazole 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 requires gastric acid for absorption, so dexlansoprazole can substantially reduce its levels and cause antifungal failure.
How serious is the interaction between Dexlansoprazole 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 where possible and consider fluconazole or another alternative. If unavoidable, monitor clinical response.
What other medicines interact with Dexlansoprazole?
MediHelp also lists interactions of Dexlansoprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Dexlansoprazole page.
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