Drug interactions
Ketoconazole + Pirtobrutinib
Severity: Major
Ketoconazole and Pirtobrutinib: 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 pirtobrutinib exposure, raising the risk of adverse effects such as bleeding, infection, cytopenias and arrhythmias.
What this interaction means in plain words
Ketoconazole and Pirtobrutinib 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; Pirtobrutinib belongs to Oncology.
Why it happens
Strong inhibition of CYP3A4-mediated metabolism of pirtobrutinib.
What to do
Choose an alternative antifungal if possible; otherwise reduce the pirtobrutinib dose per labeling and monitor for toxicity, resuming the original dose after the inhibitor has been cleared.
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 Pirtobrutinib
Frequently asked questions
Can I take Ketoconazole with Pirtobrutinib?
MediHelp rates the interaction as major. Ketoconazole and Pirtobrutinib 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 pirtobrutinib exposure, raising the risk of adverse effects such as bleeding, infection, cytopenias and arrhythmias.
How serious is the interaction between Ketoconazole and Pirtobrutinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Choose an alternative antifungal if possible; otherwise reduce the pirtobrutinib dose per labeling and monitor for toxicity, resuming the original dose after the inhibitor has been cleared.
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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