Drug interactions
Ketoconazole + Lapatinib
Severity: Major
Ketoconazole and Lapatinib: 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 lapatinib exposure, raising the risk of QT prolongation, hepatotoxicity and diarrhea.
What this interaction means in plain words
Ketoconazole and Lapatinib 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 belongs to Anti Fungals; Lapatinib belongs to Oncology.
Why it happens
Strong CYP3A4 inhibition (and possible P-gp inhibition) decreases lapatinib clearance.
What to do
Avoid the combination and choose a non-inhibiting alternative. If it cannot be avoided, reduce lapatinib to the labeled lower dose and monitor ECG and liver tests.
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 Lapatinib
- Dofetilide + Lapatinib Contraindicated
- Ibutilide + Lapatinib Contraindicated
- Lapatinib + Pimozide Contraindicated
- Lapatinib + Saquinavir Contraindicated
- Lapatinib + Thioridazine Contraindicated
- Adagrasib + Lapatinib Major
Frequently asked questions
Can I take Ketoconazole with Lapatinib?
MediHelp rates the interaction as major. Ketoconazole and Lapatinib 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 lapatinib exposure, raising the risk of QT prolongation, hepatotoxicity and diarrhea.
How serious is the interaction between Ketoconazole and Lapatinib?
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 and choose a non-inhibiting alternative. If it cannot be avoided, reduce lapatinib to the labeled lower dose and monitor ECG and liver tests.
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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