Drug interactions
Ketoconazole + Metformin-pioglitazone
Severity: Moderate
Ketoconazole and Metformin-pioglitazone: 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 raise pioglitazone exposure and so increase glucose-lowering effects and adverse effects such as edema. Ketoconazole itself has also been linked to altered glucose handling.
What this interaction means in plain words
Ketoconazole and Metformin-pioglitazone 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; Metformin-pioglitazone belongs to Endocrine.
Why it happens
Ketoconazole inhibits CYP2C8 (and CYP3A4), which are involved in pioglitazone metabolism.
What to do
Monitor blood glucose more frequently and watch for edema or hypoglycemia. Reduce the pioglitazone dose if needed.
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 Metformin-pioglitazone
Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Frequently asked questions
Can I take Ketoconazole with Metformin-pioglitazone?
MediHelp rates the interaction as moderate. Ketoconazole and Metformin-pioglitazone 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 raise pioglitazone exposure and so increase glucose-lowering effects and adverse effects such as edema. Ketoconazole itself has also been linked to altered glucose handling.
How serious is the interaction between Ketoconazole and Metformin-pioglitazone?
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 blood glucose more frequently and watch for edema or hypoglycemia. Reduce the pioglitazone dose if needed.
What other medicines interact with Metformin-pioglitazone?
MediHelp also lists interactions of Metformin-pioglitazone with, for example, Contrast media, Diatrizoate meglumine / diatrizoate, Diatrizoate. The full list is on the Metformin-pioglitazone page.
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