Drug interactions
Epinephrine + Ketoconazole
Severity: Moderate
Epinephrine 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
Both have been associated with QT prolongation, but epinephrine is typically used briefly and the clinical significance of this pairing is limited. Arrhythmia risk is mainly relevant with repeated or high doses in patients with other QT risk factors.
What this interaction means in plain words
Epinephrine 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.
Epinephrine belongs to Endocrine; Ketoconazole belongs to Anti Fungals.
Why it happens
Possible additive QT prolongation; the effect of epinephrine is mainly pharmacodynamic via adrenergic stimulation.
What to do
Do not withhold epinephrine in emergencies such as anaphylaxis. In patients on ketoconazole requiring repeated or infused epinephrine, monitor ECG and electrolytes.
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
Other interactions of Epinephrine
- Epinephrine + Isocarboxazid Contraindicated
- Epinephrine + Phenelzine Contraindicated
- Epinephrine + Tranylcypromine Contraindicated
- Acebutolol + Epinephrine Major
- Amitriptyline + Epinephrine Major
- Amoxapine + Epinephrine Major
Frequently asked questions
Can I take Epinephrine with Ketoconazole?
MediHelp rates the interaction as moderate. Epinephrine 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. Both have been associated with QT prolongation, but epinephrine is typically used briefly and the clinical significance of this pairing is limited. Arrhythmia risk is mainly relevant with repeated or high doses in patients with other QT risk factors.
How serious is the interaction between Epinephrine 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: Do not withhold epinephrine in emergencies such as anaphylaxis. In patients on ketoconazole requiring repeated or infused epinephrine, monitor ECG and electrolytes.
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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