Drug interactions
Ketoconazole + Perampanel
Severity: Moderate
Ketoconazole and Perampanel: 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 increases perampanel exposure and prolongs its half-life, which may worsen dizziness, somnolence, ataxia and psychiatric adverse effects such as irritability or aggression.
What this interaction means in plain words
Ketoconazole and Perampanel 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; Perampanel belongs to Central Nervous System.
Why it happens
Ketoconazole inhibits CYP3A4, the main enzyme metabolizing perampanel.
What to do
Monitor for CNS and behavioral adverse effects, and slow perampanel titration or reduce the dose if they occur.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ketoconazole and Perampanel, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Perampanel
- Apalutamide + Perampanel Major
- Enzalutamide + Perampanel Major
- Alprazolam + Perampanel Moderate
- Amisulpride + Perampanel Moderate
- Amobarbital + Perampanel Moderate
- Asenapine + Perampanel Moderate
Frequently asked questions
Can I take Ketoconazole with Perampanel?
MediHelp rates the interaction as moderate. Ketoconazole and Perampanel 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 increases perampanel exposure and prolongs its half-life, which may worsen dizziness, somnolence, ataxia and psychiatric adverse effects such as irritability or aggression.
How serious is the interaction between Ketoconazole and Perampanel?
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 for CNS and behavioral adverse effects, and slow perampanel titration or reduce the dose if they occur.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
