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Drug interactions

Elagolix + Ketoconazole

Severity: Major

Elagolix and Ketoconazole: major 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

Strong CYP3A inhibition by ketoconazole increases elagolix exposure, raising the risk of dose-related effects such as bone mineral density loss and liver enzyme elevations. Risk is greater with longer duration of use.

What this interaction means in plain words

Elagolix 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.

Elagolix belongs to Musculoskeletal; Ketoconazole belongs to Anti Fungals.

Evidence level: High

Why it happens

Ketoconazole inhibits CYP3A4-mediated metabolism of elagolix.

What to do

Avoid long-term use with the 200 mg twice-daily dose; if the combination is needed, limit elagolix to 150 mg once daily and restrict the inhibitor course to a maximum of 6 months.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Elagolix with Ketoconazole?

MediHelp rates the interaction as major. Elagolix 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. Strong CYP3A inhibition by ketoconazole increases elagolix exposure, raising the risk of dose-related effects such as bone mineral density loss and liver enzyme elevations. Risk is greater with longer duration of use.

How serious is the interaction between Elagolix 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 long-term use with the 200 mg twice-daily dose; if the combination is needed, limit elagolix to 150 mg once daily and restrict the inhibitor course to a maximum of 6 months.

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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