Drug interactions
Doxorubicin + Ketoconazole
Severity: Major
Doxorubicin 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 may increase doxorubicin exposure and thus the risk of myelosuppression, mucositis and cardiotoxicity. Data are limited, but doxorubicin has a narrow therapeutic index.
What this interaction means in plain words
Doxorubicin 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.
Doxorubicin belongs to Oncology; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits P-glycoprotein and CYP3A4, reducing doxorubicin elimination.
What to do
Avoid the combination where an alternative antifungal is available. If used, monitor blood counts and cardiac function and consider a doxorubicin dose reduction.
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 Doxorubicin
Frequently asked questions
Can I take Doxorubicin with Ketoconazole?
MediHelp rates the interaction as major. Doxorubicin 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 may increase doxorubicin exposure and thus the risk of myelosuppression, mucositis and cardiotoxicity. Data are limited, but doxorubicin has a narrow therapeutic index.
How serious is the interaction between Doxorubicin 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 an alternative antifungal is available. If used, monitor blood counts and cardiac function and consider a doxorubicin dose reduction.
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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