Drug interactions
Enzalutamide + Ketoconazole
Severity: Major
Enzalutamide 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
Enzalutamide may considerably reduce ketoconazole concentrations, risking antifungal treatment failure.
What this interaction means in plain words
Enzalutamide 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.
Enzalutamide belongs to Endocrine; Ketoconazole belongs to Anti Fungals.
Why it happens
Enzalutamide is a strong CYP3A4 inducer that increases ketoconazole metabolism.
What to do
Avoid the combination and choose an antifungal less affected by induction. If unavoidable, monitor antifungal response and increase ketoconazole dose if necessary.
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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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 Enzalutamide
- Doravirine + Enzalutamide Contraindicated
- Elbasvir / grazoprevir + Enzalutamide Contraindicated
- Ensitrelvir + Enzalutamide Contraindicated
- Enzalutamide + Fostemsavir Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
- Enzalutamide + Lenacapavir Contraindicated
Frequently asked questions
Can I take Enzalutamide with Ketoconazole?
MediHelp rates the interaction as major. Enzalutamide 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. Enzalutamide may considerably reduce ketoconazole concentrations, risking antifungal treatment failure.
How serious is the interaction between Enzalutamide 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 and choose an antifungal less affected by induction. If unavoidable, monitor antifungal response and increase ketoconazole dose if necessary.
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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