Drug interactions
Ketoconazole + Paliperidone
Severity: Moderate
Ketoconazole and Paliperidone: 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 increased paliperidone concentrations in studies, and both drugs can prolong the QT interval. This may raise the risk of QT prolongation and arrhythmia, especially with other risk factors.
What this interaction means in plain words
Ketoconazole and Paliperidone 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; Paliperidone belongs to Central Nervous System.
Why it happens
Ketoconazole inhibits P-glycoprotein-mediated efflux of paliperidone, and both agents have additive QT-prolonging effects.
What to do
Obtain an ECG and check potassium and magnesium in at-risk patients, and consider reducing the paliperidone dose. Avoid additional QT-prolonging drugs.
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 Paliperidone
- Ibutilide + Paliperidone Contraindicated
- Paliperidone + Pimozide Contraindicated
- Paliperidone + Vandetanib Contraindicated
- Adagrasib + Paliperidone Major
- Amiodarone + Paliperidone Major
- Amisulpride + Paliperidone Major
Frequently asked questions
Can I take Ketoconazole with Paliperidone?
MediHelp rates the interaction as moderate. Ketoconazole and Paliperidone 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 increased paliperidone concentrations in studies, and both drugs can prolong the QT interval. This may raise the risk of QT prolongation and arrhythmia, especially with other risk factors.
How serious is the interaction between Ketoconazole and Paliperidone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain an ECG and check potassium and magnesium in at-risk patients, and consider reducing the paliperidone dose. Avoid additional QT-prolonging drugs.
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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