Drug interactions
Ketoconazole + Osilodrostat
Severity: Major
Ketoconazole and Osilodrostat: 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 osilodrostat exposure, which may cause excessive cortisol suppression, adrenal insufficiency and QT prolongation. Ketoconazole is itself a steroidogenesis inhibitor, which adds to this effect.
What this interaction means in plain words
Ketoconazole and Osilodrostat 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; Osilodrostat belongs to Endocrine.
Why it happens
CYP3A4 inhibition reduces osilodrostat clearance, with additive inhibition of adrenal steroidogenesis.
What to do
Halve the osilodrostat dose if the combination is required and monitor cortisol, potassium and ECG.
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 Osilodrostat
Frequently asked questions
Can I take Ketoconazole with Osilodrostat?
MediHelp rates the interaction as major. Ketoconazole and Osilodrostat 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 osilodrostat exposure, which may cause excessive cortisol suppression, adrenal insufficiency and QT prolongation. Ketoconazole is itself a steroidogenesis inhibitor, which adds to this effect.
How serious is the interaction between Ketoconazole and Osilodrostat?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Halve the osilodrostat dose if the combination is required and monitor cortisol, potassium and ECG.
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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