Drug interactions
Ketoconazole + Prednisone
Severity: Moderate
Ketoconazole and Prednisone: moderate interaction.
Last updated Sources: US FDA label
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 raise corticosteroid exposure and may enhance steroid effects such as hyperglycemia, fluid retention and adrenal suppression. It also inhibits adrenal steroid synthesis, which adds complexity.
What this interaction means in plain words
Ketoconazole and Prednisone 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; Prednisone belongs to Endocrine.
Why it happens
Ketoconazole inhibits CYP3A4 and P-glycoprotein, reducing corticosteroid clearance.
What to do
Monitor for corticosteroid excess and consider reducing the prednisone dose during prolonged coadministration.
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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References
- Prednisone - FDA drug label (DailyMed) — openFDA / DailyMed
Other interactions of Prednisone
- Bcg vaccine live + Prednisone Contraindicated
- Measles vaccine + Prednisone Contraindicated
- Mifepristone + Prednisone Contraindicated
- Prednisone + Radium-223 dichloride Contraindicated
- Prednisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Prednisone Major
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 Prednisone?
MediHelp rates the interaction as moderate. Ketoconazole and Prednisone 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 raise corticosteroid exposure and may enhance steroid effects such as hyperglycemia, fluid retention and adrenal suppression. It also inhibits adrenal steroid synthesis, which adds complexity.
How serious is the interaction between Ketoconazole and Prednisone?
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 and consider reducing the prednisone dose during prolonged coadministration.
What other medicines interact with Prednisone?
MediHelp also lists interactions of Prednisone with, for example, Bcg vaccine live, Measles vaccine, Mifepristone. The full list is on the Prednisone page.
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