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Drug interactions

Fosaprepitant + Ketoconazole

Severity: Moderate

Fosaprepitant 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 increases aprepitant exposure, the active form of fosaprepitant. The clinical consequences are usually modest, though adverse effects like fatigue and hiccups may increase.

What this interaction means in plain words

Fosaprepitant 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.

Fosaprepitant belongs to Gastrointestinal Tract; Ketoconazole belongs to Anti Fungals.

Evidence level: Moderate

Why it happens

Ketoconazole inhibits CYP3A4 metabolism of aprepitant.

What to do

Monitor for aprepitant adverse effects; no dose change is required for a single IV dose.

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?

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 Fosaprepitant with Ketoconazole?

MediHelp rates the interaction as moderate. Fosaprepitant 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 increases aprepitant exposure, the active form of fosaprepitant. The clinical consequences are usually modest, though adverse effects like fatigue and hiccups may increase.

How serious is the interaction between Fosaprepitant 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 aprepitant adverse effects; no dose change is required for a single IV dose.

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

Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.

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