Drug interactions
Ketoconazole + Maraviroc
Severity: Major
Ketoconazole and Maraviroc: 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 markedly increases maraviroc exposure, raising the risk of adverse effects such as postural hypotension, hepatotoxicity and cardiovascular events. Labeling requires a lower maraviroc dose with strong CYP3A inhibitors.
What this interaction means in plain words
Ketoconazole and Maraviroc 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; Maraviroc belongs to Anti Virals.
Why it happens
Ketoconazole inhibits CYP3A4 and P-glycoprotein, reducing maraviroc metabolism and efflux.
What to do
Reduce maraviroc to 150 mg twice daily when given with ketoconazole in adults, following labeling for other populations. Monitor for hypotension and liver toxicity.
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 Maraviroc
- Amobarbital + Maraviroc Major
- Apalutamide + Maraviroc Major
- Carbamazepine + Maraviroc Major
- Clarithromycin + Maraviroc Major
- Efavirenz + Maraviroc Major
- Enzalutamide + Maraviroc Major
Frequently asked questions
Can I take Ketoconazole with Maraviroc?
MediHelp rates the interaction as major. Ketoconazole and Maraviroc 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 markedly increases maraviroc exposure, raising the risk of adverse effects such as postural hypotension, hepatotoxicity and cardiovascular events. Labeling requires a lower maraviroc dose with strong CYP3A inhibitors.
How serious is the interaction between Ketoconazole and Maraviroc?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce maraviroc to 150 mg twice daily when given with ketoconazole in adults, following labeling for other populations. Monitor for hypotension and liver toxicity.
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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