Drug interactions
Ketoconazole + Methylprednisolone
Severity: Major
Ketoconazole and Methylprednisolone: 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 strongly inhibits CYP3A4 and substantially increases methylprednisolone exposure. This raises the risk of systemic corticosteroid effects including Cushingoid features, adrenal suppression, hyperglycemia and infection.
What this interaction means in plain words
Ketoconazole and Methylprednisolone 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; Methylprednisolone belongs to Endocrine.
Why it happens
Inhibition of CYP3A4 by ketoconazole decreases methylprednisolone clearance.
What to do
Reduce the methylprednisolone dose and monitor for corticosteroid toxicity and glucose changes. Consider an alternative antifungal if feasible.
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 Methylprednisolone
- Bcg vaccine live + Methylprednisolone Contraindicated
- Measles mumps and rubella vaccine live + Methylprednisolone Contraindicated
- Measles mumps rubella and varicella vaccine live + Methylprednisolone Contraindicated
- Measles vaccine + Methylprednisolone Contraindicated
- Methylprednisolone + Mifepristone Contraindicated
- Methylprednisolone + Rubella vaccine Contraindicated
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 Methylprednisolone?
MediHelp rates the interaction as major. Ketoconazole and Methylprednisolone 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 strongly inhibits CYP3A4 and substantially increases methylprednisolone exposure. This raises the risk of systemic corticosteroid effects including Cushingoid features, adrenal suppression, hyperglycemia and infection.
How serious is the interaction between Ketoconazole and Methylprednisolone?
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 the methylprednisolone dose and monitor for corticosteroid toxicity and glucose changes. Consider an alternative antifungal if feasible.
What other medicines interact with Methylprednisolone?
MediHelp also lists interactions of Methylprednisolone with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Methylprednisolone page.
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