Drug interactions
Dienogest / estradiol valerate + Ketoconazole
Severity: Moderate
Dienogest / estradiol valerate 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 can increase exposure to both dienogest and estradiol. This may heighten hormonal adverse effects such as nausea, breast tenderness, headache and irregular bleeding.
What this interaction means in plain words
Dienogest / estradiol valerate 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.
Why it happens
Strong CYP3A4 inhibition by ketoconazole reduces the metabolism of dienogest and estradiol.
What to do
Monitor for hormonal adverse effects and bleeding changes during concomitant use. Consider an alternative antifungal if effects are troublesome.
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
Frequently asked questions
Can I take Dienogest / estradiol valerate with Ketoconazole?
MediHelp rates the interaction as moderate. Dienogest / estradiol valerate 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 can increase exposure to both dienogest and estradiol. This may heighten hormonal adverse effects such as nausea, breast tenderness, headache and irregular bleeding.
How serious is the interaction between Dienogest / estradiol valerate 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 hormonal adverse effects and bleeding changes during concomitant use. Consider an alternative antifungal if effects are troublesome.
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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