Drug interactions
Ivermectin + Ketoconazole
Severity: Minor
Ivermectin and Ketoconazole: minor 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 may increase ivermectin exposure through reduced efflux, potentially increasing its effects. Clinical consequences are generally limited given ivermectin's wide safety margin at standard doses.
What this interaction means in plain words
Ivermectin and Ketoconazole have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Ivermectin belongs to Anti Parasitic; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits P-glycoprotein and CYP3A4, which are involved in ivermectin disposition.
What to do
No routine dose change is needed; watch for neurological adverse effects such as dizziness or ataxia, particularly with high or repeated ivermectin doses.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Ivermectin
- Erdafitinib + Ivermectin Moderate
- Ivermectin + Lasmiditan Moderate
- Ivermectin + Quinidine Moderate
- Ivermectin + Rifampin Moderate
- Ivermectin + Sotorasib Moderate
- Ivermectin + Tepotinib Moderate
Frequently asked questions
Can I take Ivermectin with Ketoconazole?
MediHelp rates the interaction as minor. Ivermectin and Ketoconazole have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Ketoconazole may increase ivermectin exposure through reduced efflux, potentially increasing its effects. Clinical consequences are generally limited given ivermectin's wide safety margin at standard doses.
How serious is the interaction between Ivermectin and Ketoconazole?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine dose change is needed; watch for neurological adverse effects such as dizziness or ataxia, particularly with high or repeated ivermectin doses.
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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