Drug interactions
Ketoconazole + Neomycin
Severity: Minor
Ketoconazole and Neomycin: minor 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 inhibits P-glycoprotein, which could theoretically raise absorption of oral neomycin. Because neomycin is minimally absorbed, a clinically meaningful increase in systemic exposure is unlikely in most patients.
What this interaction means in plain words
Ketoconazole and Neomycin have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Ketoconazole belongs to Anti Fungals; Neomycin belongs to Anti Bacterial.
Why it happens
P-glycoprotein inhibition by ketoconazole may slightly increase neomycin absorption, but the clinical importance is unestablished.
What to do
No routine action is needed. Monitor renal function and hearing if neomycin is given long term or the patient has renal impairment.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Neomycin
- Amikacin + Neomycin Major
- Amphotericin b deoxycholate + Neomycin Major
- Capreomycin + Neomycin Major
- Cidofovir + Neomycin Major
- Colistin + Neomycin Major
- Ethacrynic acid + Neomycin Major
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 Neomycin?
MediHelp rates the interaction as minor. Ketoconazole and Neomycin have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Ketoconazole inhibits P-glycoprotein, which could theoretically raise absorption of oral neomycin. Because neomycin is minimally absorbed, a clinically meaningful increase in systemic exposure is unlikely in most patients.
How serious is the interaction between Ketoconazole and Neomycin?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine action is needed. Monitor renal function and hearing if neomycin is given long term or the patient has renal impairment.
What other medicines interact with Neomycin?
MediHelp also lists interactions of Neomycin with, for example, Amikacin, Amphotericin b deoxycholate, Capreomycin. The full list is on the Neomycin page.
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