Drug interactions
Ketoconazole + Lenacapavir
Severity: Moderate
Ketoconazole and Lenacapavir: 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
Combined inhibition of CYP3A, P-gp and UGT1A1 by ketoconazole may raise lenacapavir concentrations considerably. Increased exposure could worsen adverse reactions such as injection-site effects and nausea.
What this interaction means in plain words
Ketoconazole and Lenacapavir 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; Lenacapavir belongs to Anti Virals.
Why it happens
Ketoconazole inhibits CYP3A4, P-gp and possibly UGT1A1, which are involved in lenacapavir elimination.
What to do
Where possible choose an antifungal that does not strongly inhibit CYP3A. If combined, monitor for adverse reactions.
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 Lenacapavir
- Apalutamide + Lenacapavir Contraindicated
- Carbamazepine + Lenacapavir Contraindicated
- Enzalutamide + Lenacapavir Contraindicated
- Flibanserin + Lenacapavir Contraindicated
- Lenacapavir + Phenytoin Contraindicated
- Lenacapavir + Rifampicin Contraindicated
Frequently asked questions
Can I take Ketoconazole with Lenacapavir?
MediHelp rates the interaction as moderate. Ketoconazole and Lenacapavir 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. Combined inhibition of CYP3A, P-gp and UGT1A1 by ketoconazole may raise lenacapavir concentrations considerably. Increased exposure could worsen adverse reactions such as injection-site effects and nausea.
How serious is the interaction between Ketoconazole and Lenacapavir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Where possible choose an antifungal that does not strongly inhibit CYP3A. If combined, monitor for adverse reactions.
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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