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Drug interactions

Fedratinib + Ketoconazole

Severity: Major

Fedratinib 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

Ketoconazole raises fedratinib exposure, increasing the risk of GI toxicity, myelosuppression and encephalopathy including Wernicke's.

What this interaction means in plain words

Fedratinib 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.

Fedratinib belongs to Oncology; Ketoconazole belongs to Anti Fungals.

Evidence level: High

Why it happens

Ketoconazole inhibits CYP3A4, a major pathway of fedratinib metabolism.

What to do

Avoid if possible; otherwise reduce fedratinib to the labeled dose and monitor for toxicity and thiamine status. Restore the dose after the inhibitor is stopped.

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 Fedratinib with Ketoconazole?

MediHelp rates the interaction as major. Fedratinib 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. Ketoconazole raises fedratinib exposure, increasing the risk of GI toxicity, myelosuppression and encephalopathy including Wernicke's.

How serious is the interaction between Fedratinib 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 if possible; otherwise reduce fedratinib to the labeled dose and monitor for toxicity and thiamine status. Restore the dose after the inhibitor is 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.

Full monographs, dosing and an interaction checker in the MediHelp app

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