Drug interactions
Ketoconazole + Midostaurin
Severity: Major
Ketoconazole and Midostaurin: 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 increases midostaurin exposure, which may increase adverse effects such as nausea, infections and QT prolongation.
What this interaction means in plain words
Ketoconazole and Midostaurin 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; Midostaurin belongs to Oncology.
Why it happens
Strong CYP3A4 inhibition reduces midostaurin clearance.
What to do
Consider alternatives to strong CYP3A4 inhibitors. If unavoidable, monitor closely for toxicity, especially during the first week of therapy.
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 Midostaurin
Frequently asked questions
Can I take Ketoconazole with Midostaurin?
MediHelp rates the interaction as major. Ketoconazole and Midostaurin 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 increases midostaurin exposure, which may increase adverse effects such as nausea, infections and QT prolongation.
How serious is the interaction between Ketoconazole and Midostaurin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider alternatives to strong CYP3A4 inhibitors. If unavoidable, monitor closely for toxicity, especially during the first week of therapy.
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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