Drug interactions
Felodipine + Ketoconazole
Severity: Major
Felodipine 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 greatly increases felodipine exposure, leading to excessive vasodilation with hypotension, peripheral edema, flushing and tachycardia.
What this interaction means in plain words
Felodipine 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.
Felodipine belongs to Cardiovascular; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits intestinal and hepatic CYP3A4, reducing felodipine first-pass metabolism.
What to do
Avoid the combination or use a calcium channel blocker less dependent on CYP3A4. If used together, start with a low felodipine dose and monitor blood pressure and edema.
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 Felodipine
- Felodipine + Itraconazole Contraindicated
- Aldesleukin + Felodipine Major
- Amifostine + Felodipine Major
- Apalutamide + Felodipine Major
- Atazanavir + Felodipine Major
- Carbamazepine + Felodipine Major
Frequently asked questions
Can I take Felodipine with Ketoconazole?
MediHelp rates the interaction as major. Felodipine 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 greatly increases felodipine exposure, leading to excessive vasodilation with hypotension, peripheral edema, flushing and tachycardia.
How serious is the interaction between Felodipine 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 or use a calcium channel blocker less dependent on CYP3A4. If used together, start with a low felodipine dose and monitor blood pressure and edema.
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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