Drug interactions
Ketoconazole + Lacosamide
Severity: Moderate
Ketoconazole and Lacosamide: 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 may increase lacosamide exposure, mainly in patients with renal or hepatic impairment. This can lead to dizziness, ataxia and PR-interval prolongation.
What this interaction means in plain words
Ketoconazole and Lacosamide 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 belongs to Anti Fungals; Lacosamide belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4 and CYP2C9 reduces lacosamide metabolism, although other pathways limit the effect in healthy patients.
What to do
Monitor for dizziness, cardiac conduction effects and sedation, and reduce the lacosamide dose in renal or hepatic impairment.
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?
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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 Lacosamide
- Lacosamide + Zuranolone Major
- Atazanavir + Lacosamide Moderate
- Carbamazepine + Lacosamide Moderate
- Cenobamate + Lacosamide Moderate
- Clarithromycin + Lacosamide Moderate
- Daridorexant + Lacosamide Moderate
Frequently asked questions
Can I take Ketoconazole with Lacosamide?
MediHelp rates the interaction as moderate. Ketoconazole and Lacosamide 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 may increase lacosamide exposure, mainly in patients with renal or hepatic impairment. This can lead to dizziness, ataxia and PR-interval prolongation.
How serious is the interaction between Ketoconazole and Lacosamide?
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 dizziness, cardiac conduction effects and sedation, and reduce the lacosamide dose in renal or hepatic impairment.
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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