Drug interactions
Gilteritinib + Ketoconazole
Severity: Major
Gilteritinib 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 substantially increases gilteritinib exposure, raising the risk of QT prolongation, differentiation syndrome, hepatotoxicity and myelosuppression.
What this interaction means in plain words
Gilteritinib 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.
Gilteritinib belongs to Oncology; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits CYP3A4 and P-glycoprotein, reducing gilteritinib clearance.
What to do
Use an alternative antifungal if possible; otherwise monitor ECG, electrolytes and liver function closely. Interrupt or reduce gilteritinib for serious toxicity.
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 Gilteritinib
- Gilteritinib + Pimozide Contraindicated
- Amiodarone + Gilteritinib Major
- Amisulpride + Gilteritinib Major
- Amitriptyline + Gilteritinib Major
- Anagrelide + Gilteritinib Major
- Apalutamide + Gilteritinib Major
Frequently asked questions
Can I take Gilteritinib with Ketoconazole?
MediHelp rates the interaction as major. Gilteritinib 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 substantially increases gilteritinib exposure, raising the risk of QT prolongation, differentiation syndrome, hepatotoxicity and myelosuppression.
How serious is the interaction between Gilteritinib 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: Use an alternative antifungal if possible; otherwise monitor ECG, electrolytes and liver function closely. Interrupt or reduce gilteritinib for serious toxicity.
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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