Drug interactions
Ketoconazole + Panobinostat
Severity: Major
Ketoconazole and Panobinostat: 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 panobinostat exposure, which increases the risk of diarrhea, myelosuppression and cardiac toxicity including QT prolongation.
What this interaction means in plain words
Ketoconazole and Panobinostat 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; Panobinostat belongs to Oncology.
Why it happens
Strong CYP3A4 inhibition reduces panobinostat metabolism.
What to do
Reduce the panobinostat starting dose to 10 mg and monitor blood counts, ECG and gastrointestinal toxicity.
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 Panobinostat
- Amiodarone + Panobinostat Contraindicated
- Anagrelide + Panobinostat Contraindicated
- Chloroquine + Panobinostat Contraindicated
- Chlorpromazine + Panobinostat Contraindicated
- Dronedarone + Panobinostat Contraindicated
- Haloperidol + Panobinostat Contraindicated
Frequently asked questions
Can I take Ketoconazole with Panobinostat?
MediHelp rates the interaction as major. Ketoconazole and Panobinostat 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 panobinostat exposure, which increases the risk of diarrhea, myelosuppression and cardiac toxicity including QT prolongation.
How serious is the interaction between Ketoconazole and Panobinostat?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the panobinostat starting dose to 10 mg and monitor blood counts, ECG and gastrointestinal toxicity.
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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