Drug interactions
Ketoconazole + Parecoxib
Severity: Moderate
Ketoconazole and Parecoxib: 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 can increase exposure to valdecoxib, the active metabolite of parecoxib, raising the risk of COX-2 inhibitor adverse effects such as renal, gastrointestinal and cardiovascular events.
What this interaction means in plain words
Ketoconazole and Parecoxib 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.
Why it happens
Ketoconazole inhibits CYP3A4 and CYP2C9, which metabolize valdecoxib.
What to do
Use the lowest effective parecoxib dose for the shortest duration, and monitor blood pressure and renal function.
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
Frequently asked questions
Can I take Ketoconazole with Parecoxib?
MediHelp rates the interaction as moderate. Ketoconazole and Parecoxib 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 can increase exposure to valdecoxib, the active metabolite of parecoxib, raising the risk of COX-2 inhibitor adverse effects such as renal, gastrointestinal and cardiovascular events.
How serious is the interaction between Ketoconazole and Parecoxib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective parecoxib dose for the shortest duration, and monitor blood pressure and renal function.
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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