Drug interactions
Ketoconazole + Lovastatin
Severity: Contraindicated
Ketoconazole and Lovastatin: contraindicated 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 greatly increases lovastatin exposure. This raises the risk of myopathy and rhabdomyolysis with possible kidney injury. Labeling contraindicates the combination.
What this interaction means in plain words
Ketoconazole and Lovastatin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Ketoconazole belongs to Anti Fungals; Lovastatin belongs to Cardiovascular.
Why it happens
Ketoconazole is a strong CYP3A4 inhibitor and blocks the extensive first-pass and hepatic metabolism of lovastatin.
What to do
Do not combine. Suspend lovastatin during ketoconazole therapy or use a statin not dependent on CYP3A4, such as pravastatin or rosuvastatin.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Lovastatin
- Atazanavir + Lovastatin Contraindicated
- Clarithromycin + Lovastatin Contraindicated
- Cobicistat + Lovastatin Contraindicated
- Conivaptan + Lovastatin Contraindicated
- Darunavir + Lovastatin Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Lovastatin Contraindicated
Frequently asked questions
Can I take Ketoconazole with Lovastatin?
MediHelp rates the interaction as contraindicated. Ketoconazole and Lovastatin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ketoconazole greatly increases lovastatin exposure. This raises the risk of myopathy and rhabdomyolysis with possible kidney injury. Labeling contraindicates the combination.
How serious is the interaction between Ketoconazole and Lovastatin?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not combine. Suspend lovastatin during ketoconazole therapy or use a statin not dependent on CYP3A4, such as pravastatin or rosuvastatin.
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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