Drug interactions
Ketoconazole + Paclitaxel
Severity: Moderate
Ketoconazole and Paclitaxel: 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 may raise paclitaxel exposure and increase risks of neutropenia, neuropathy and other dose-related toxicity. In vivo effects appear variable because paclitaxel is metabolized by several pathways.
What this interaction means in plain words
Ketoconazole and Paclitaxel 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; Paclitaxel belongs to Oncology.
Why it happens
Ketoconazole inhibits CYP3A4 and P-glycoprotein, reducing paclitaxel metabolism and efflux (CYP2C8 is the main pathway).
What to do
Monitor blood counts and neuropathy, and reduce the paclitaxel dose if toxicity develops. Choose a non-azole antifungal where possible.
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 Paclitaxel
Frequently asked questions
Can I take Ketoconazole with Paclitaxel?
MediHelp rates the interaction as moderate. Ketoconazole and Paclitaxel 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 may raise paclitaxel exposure and increase risks of neutropenia, neuropathy and other dose-related toxicity. In vivo effects appear variable because paclitaxel is metabolized by several pathways.
How serious is the interaction between Ketoconazole and Paclitaxel?
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 blood counts and neuropathy, and reduce the paclitaxel dose if toxicity develops. Choose a non-azole antifungal where possible.
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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