Drug interactions
Etrasimod + Ketoconazole
Severity: Moderate
Etrasimod 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
Etrasimod is cleared by CYP2C8, CYP2C9 and CYP3A4. Ketoconazole inhibits CYP3A4 and can modestly raise exposure, and labeling cautions against drugs that inhibit multiple pathways, which could increase bradycardia and other effects.
What this interaction means in plain words
Etrasimod 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.
Etrasimod belongs to Gastrointestinal Tract; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits CYP3A4 (and weakly CYP2C9), reducing etrasimod clearance.
What to do
Monitor heart rate and for adverse effects when starting or stopping ketoconazole. Avoid it if the patient also takes a CYP2C9 inhibitor.
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 Etrasimod
- Abatacept + Etrasimod Major
- Amiodarone + Etrasimod Major
- Anagrelide + Etrasimod Major
- Anakinra + Etrasimod Major
- Anti-thymocyte + Etrasimod Major
- Asenapine + Etrasimod Major
Frequently asked questions
Can I take Etrasimod with Ketoconazole?
MediHelp rates the interaction as moderate. Etrasimod 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. Etrasimod is cleared by CYP2C8, CYP2C9 and CYP3A4. Ketoconazole inhibits CYP3A4 and can modestly raise exposure, and labeling cautions against drugs that inhibit multiple pathways, which could increase bradycardia and other effects.
How serious is the interaction between Etrasimod 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 heart rate and for adverse effects when starting or stopping ketoconazole. Avoid it if the patient also takes a CYP2C9 inhibitor.
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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