Drug interactions
Ketoconazole + Olaparib
Severity: Major
Ketoconazole and Olaparib: major 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 olaparib exposure, which can worsen anemia, neutropenia and other adverse effects.
What this interaction means in plain words
Ketoconazole and Olaparib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Ketoconazole belongs to Anti Fungals; Olaparib belongs to Oncology.
Why it happens
Strong CYP3A4 inhibition by ketoconazole reduces olaparib metabolism.
What to do
Avoid if possible; otherwise reduce olaparib to 100 mg twice daily and monitor blood counts. Restore the prior dose after the inhibitor has been stopped for about 3 to 5 half-lives.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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 Olaparib
- Amiodarone + Olaparib Major
- Amobarbital + Olaparib Major
- Apalutamide + Olaparib Major
- Aprepitant + Olaparib Major
- Azathioprine + Olaparib Major
- Carbamazepine + Olaparib Major
Frequently asked questions
Can I take Ketoconazole with Olaparib?
MediHelp rates the interaction as major. Ketoconazole and Olaparib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ketoconazole increases olaparib exposure, which can worsen anemia, neutropenia and other adverse effects.
How serious is the interaction between Ketoconazole and Olaparib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; otherwise reduce olaparib to 100 mg twice daily and monitor blood counts. Restore the prior dose after the inhibitor has been stopped for about 3 to 5 half-lives.
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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