Drug interactions
Ethosuximide + Ketoconazole
Severity: Moderate
Ethosuximide 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 ethosuximide levels, with possible dizziness, nausea, drowsiness and ataxia. Evidence is limited and based on the known CYP3A4 contribution to ethosuximide metabolism.
What this interaction means in plain words
Ethosuximide 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.
Ethosuximide belongs to Central Nervous System; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits CYP3A4, a pathway of ethosuximide metabolism.
What to do
Monitor for ethosuximide toxicity and consider checking serum levels when ketoconazole is started or stopped.
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 Ethosuximide
- Benzhydrocodone / acetaminophen + Ethosuximide Major
- Buprenorphine long-acting + Ethosuximide Major
- Buprenorphine subdermal implant + Ethosuximide Major
- Buprenorphine transdermal + Ethosuximide Major
- Calcium / magnesium / potassium / sodium oxybates + Ethosuximide Major
- Ethosuximide + Fentanyl intranasal Major
Frequently asked questions
Can I take Ethosuximide with Ketoconazole?
MediHelp rates the interaction as moderate. Ethosuximide 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 ethosuximide levels, with possible dizziness, nausea, drowsiness and ataxia. Evidence is limited and based on the known CYP3A4 contribution to ethosuximide metabolism.
How serious is the interaction between Ethosuximide 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 for ethosuximide toxicity and consider checking serum levels when ketoconazole is started or stopped.
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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