Drug interactions
Ketoconazole + Nintedanib
Severity: Moderate
Ketoconazole and Nintedanib: 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 nintedanib exposure, which may worsen gastrointestinal effects such as diarrhea and nausea and raise liver enzyme elevations.
What this interaction means in plain words
Ketoconazole and Nintedanib 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; Nintedanib belongs to Oncology.
Why it happens
Inhibition of P-glycoprotein (and CYP3A4) increases nintedanib absorption and reduces clearance.
What to do
Monitor for adverse effects and liver enzymes; interrupt, reduce the dose or stop nintedanib if tolerability worsens.
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 Nintedanib
- Amiodarone + Nintedanib Moderate
- Apixaban + Nintedanib Moderate
- Argatroban + Nintedanib Moderate
- Azithromycin + Nintedanib Moderate
- Carbamazepine + Nintedanib Moderate
- Carvedilol + Nintedanib Moderate
Frequently asked questions
Can I take Ketoconazole with Nintedanib?
MediHelp rates the interaction as moderate. Ketoconazole and Nintedanib 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 nintedanib exposure, which may worsen gastrointestinal effects such as diarrhea and nausea and raise liver enzyme elevations.
How serious is the interaction between Ketoconazole and Nintedanib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for adverse effects and liver enzymes; interrupt, reduce the dose or stop nintedanib if tolerability worsens.
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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