Drug interactions
Ketoconazole + Naldemedine
Severity: Moderate
Ketoconazole and Naldemedine: 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 raises naldemedine concentrations, which may increase gastrointestinal adverse effects such as abdominal pain and diarrhea, and opioid withdrawal symptoms.
What this interaction means in plain words
Ketoconazole and Naldemedine 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; Naldemedine belongs to Gastrointestinal Tract.
Why it happens
Ketoconazole inhibits CYP3A4 and P-glycoprotein, reducing naldemedine metabolism and efflux.
What to do
No fixed dose change is required; monitor for abdominal pain, diarrhea and opioid withdrawal symptoms, and stop naldemedine if severe.
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 Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Other interactions of Naldemedine
- Bupropion-naltrexone + Naldemedine Major
- Naldemedine + Naltrexone Major
- Naldemedine + Phenytoin Major
- Naldemedine + Rifampicin Major
- Amobarbital + Naldemedine Moderate
- Apalutamide + Naldemedine Moderate
Frequently asked questions
Can I take Ketoconazole with Naldemedine?
MediHelp rates the interaction as moderate. Ketoconazole and Naldemedine 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 raises naldemedine concentrations, which may increase gastrointestinal adverse effects such as abdominal pain and diarrhea, and opioid withdrawal symptoms.
How serious is the interaction between Ketoconazole and Naldemedine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No fixed dose change is required; monitor for abdominal pain, diarrhea and opioid withdrawal symptoms, and stop naldemedine if severe.
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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