Drug interactions
Ketoconazole + Nisoldipine
Severity: Contraindicated
Ketoconazole and Nisoldipine: contraindicated 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 substantially increases nisoldipine concentrations, which can cause marked hypotension, edema and reflex tachycardia. Nisoldipine labeling contraindicates strong CYP3A4 inhibitors.
What this interaction means in plain words
Ketoconazole and Nisoldipine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Ketoconazole belongs to Anti Fungals; Nisoldipine belongs to Cardiovascular.
Why it happens
Strong CYP3A4 inhibition prevents the extensive first-pass metabolism of nisoldipine, raising its bioavailability.
What to do
Avoid the combination. Use a different antihypertensive, such as amlodipine with monitoring, or a different antifungal.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Nisoldipine
- Itraconazole + Nisoldipine Contraindicated
- Apalutamide + Nisoldipine Major
- Carbamazepine + Nisoldipine Major
- Chloramphenicol + Nisoldipine Major
- Clarithromycin + Nisoldipine Major
- Cyclosporin + Nisoldipine Major
Frequently asked questions
Can I take Ketoconazole with Nisoldipine?
MediHelp rates the interaction as contraindicated. Ketoconazole and Nisoldipine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ketoconazole substantially increases nisoldipine concentrations, which can cause marked hypotension, edema and reflex tachycardia. Nisoldipine labeling contraindicates strong CYP3A4 inhibitors.
How serious is the interaction between Ketoconazole and Nisoldipine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination. Use a different antihypertensive, such as amlodipine with monitoring, or a different antifungal.
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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