Drug interactions
Ketoconazole + Prednisolone
Severity: Moderate
Ketoconazole and Prednisolone: 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 inhibits CYP3A4 and P-glycoprotein and can modestly raise prednisolone exposure. It also inhibits adrenal steroid synthesis, which may add to adrenal suppression. Increased corticosteroid adverse effects are possible, especially with prolonged use.
What this interaction means in plain words
Ketoconazole and Prednisolone 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; Prednisolone belongs to Endocrine.
Why it happens
Ketoconazole inhibits CYP3A4 and P-glycoprotein, decreasing prednisolone clearance, and also blocks adrenal steroidogenesis.
What to do
Monitor for corticosteroid excess such as hyperglycemia, hypertension and edema, and lower the prednisolone dose if needed. Be alert for adrenal insufficiency when either drug is stopped.
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 Prednisolone, 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 Prednisolone
- Bcg vaccine live + Prednisolone Contraindicated
- Measles mumps and rubella vaccine live + Prednisolone Contraindicated
- Measles mumps rubella and varicella vaccine live + Prednisolone Contraindicated
- Measles vaccine + Prednisolone Contraindicated
- Mifepristone + Prednisolone Contraindicated
- Prednisolone + Radium-223 dichloride Contraindicated
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 Prednisolone?
MediHelp rates the interaction as moderate. Ketoconazole and Prednisolone 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 inhibits CYP3A4 and P-glycoprotein and can modestly raise prednisolone exposure. It also inhibits adrenal steroid synthesis, which may add to adrenal suppression. Increased corticosteroid adverse effects are possible, especially with prolonged use.
How serious is the interaction between Ketoconazole and Prednisolone?
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 corticosteroid excess such as hyperglycemia, hypertension and edema, and lower the prednisolone dose if needed. Be alert for adrenal insufficiency when either drug is stopped.
What other medicines interact with Prednisolone?
MediHelp also lists interactions of Prednisolone with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Prednisolone 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.
