Drug interactions
Doxorubicin liposomal + Ketoconazole
Severity: Moderate
Doxorubicin liposomal 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 may increase exposure to doxorubicin and thereby its toxicity, including myelosuppression and cardiotoxicity. The effect is predicted from mechanism rather than well quantified for the liposomal form.
What this interaction means in plain words
Doxorubicin liposomal 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
Ketoconazole inhibits CYP3A4 and P-glycoprotein, both involved in doxorubicin disposition.
What to do
Monitor blood counts and cardiac status closely, and consider an alternative antifungal not strongly inhibiting CYP3A4 or P-gp.
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 Doxorubicin liposomal with Ketoconazole?
MediHelp rates the interaction as moderate. Doxorubicin liposomal 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 may increase exposure to doxorubicin and thereby its toxicity, including myelosuppression and cardiotoxicity. The effect is predicted from mechanism rather than well quantified for the liposomal form.
How serious is the interaction between Doxorubicin liposomal 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 blood counts and cardiac status closely, and consider an alternative antifungal not strongly inhibiting CYP3A4 or P-gp.
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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