Drug interactions
Ketoconazole + Omeprazole
Severity: Major
Ketoconazole and Omeprazole: 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 needs an acidic environment for dissolution, and omeprazole substantially reduces its absorption, which may cause antifungal failure.
What this interaction means in plain words
Ketoconazole and Omeprazole 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; Omeprazole belongs to Gastrointestinal Tract.
Why it happens
Elevated gastric pH reduces ketoconazole solubility and absorption.
What to do
Avoid the combination; choose an alternative antifungal or acid-independent agent, or give ketoconazole with an acidic drink and monitor response.
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 Omeprazole
- Mavacamten + Omeprazole Contraindicated
- Omeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Omeprazole Major
- Atazanavir + Omeprazole Major
- Citalopram + Omeprazole Major
- Clopidogrel + Omeprazole 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 Omeprazole?
MediHelp rates the interaction as major. Ketoconazole and Omeprazole 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 needs an acidic environment for dissolution, and omeprazole substantially reduces its absorption, which may cause antifungal failure.
How serious is the interaction between Ketoconazole and Omeprazole?
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 the combination; choose an alternative antifungal or acid-independent agent, or give ketoconazole with an acidic drink and monitor response.
What other medicines interact with Omeprazole?
MediHelp also lists interactions of Omeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Omeprazole page.
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