Drug interactions
Ketoconazole + Netupitant / palonosetron
Severity: Moderate
Ketoconazole and Netupitant / palonosetron: 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 increases netupitant exposure substantially in pharmacokinetic studies, with a smaller effect on palonosetron. Because the product is well tolerated, this is usually not clinically significant.
What this interaction means in plain words
Ketoconazole and Netupitant / palonosetron 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.
Why it happens
Ketoconazole inhibits CYP3A4, the main metabolic pathway for netupitant.
What to do
No dose adjustment is required for a single-dose antiemetic regimen; monitor for headache, constipation and QT effects if used repeatedly.
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
Frequently asked questions
Can I take Ketoconazole with Netupitant / palonosetron?
MediHelp rates the interaction as moderate. Ketoconazole and Netupitant / palonosetron 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 increases netupitant exposure substantially in pharmacokinetic studies, with a smaller effect on palonosetron. Because the product is well tolerated, this is usually not clinically significant.
How serious is the interaction between Ketoconazole and Netupitant / palonosetron?
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 dose adjustment is required for a single-dose antiemetic regimen; monitor for headache, constipation and QT effects if used repeatedly.
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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