Drug interactions
Ketoconazole + Prochlorperazine
Severity: Major
Ketoconazole and Prochlorperazine: 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 prolongs the QT interval and strongly inhibits CYP3A4, and prochlorperazine adds further repolarization risk. The combination may lead to torsades de pointes.
What this interaction means in plain words
Ketoconazole and Prochlorperazine 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; Prochlorperazine belongs to Central Nervous System.
Why it happens
Additive QT prolongation, with possible increased phenothiazine exposure through CYP inhibition.
What to do
Avoid if possible by choosing a non-QT-prolonging antiemetic. If combined, monitor the ECG and keep potassium and magnesium normal.
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 Prochlorperazine
- Dronedarone + Prochlorperazine Contraindicated
- Ibutilide + Prochlorperazine Contraindicated
- Nilotinib + Prochlorperazine Contraindicated
- Pimozide + Prochlorperazine Contraindicated
- Prochlorperazine + Thioridazine Contraindicated
- Amiodarone + Prochlorperazine 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 Prochlorperazine?
MediHelp rates the interaction as major. Ketoconazole and Prochlorperazine 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 prolongs the QT interval and strongly inhibits CYP3A4, and prochlorperazine adds further repolarization risk. The combination may lead to torsades de pointes.
How serious is the interaction between Ketoconazole and Prochlorperazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible by choosing a non-QT-prolonging antiemetic. If combined, monitor the ECG and keep potassium and magnesium normal.
What other medicines interact with Prochlorperazine?
MediHelp also lists interactions of Prochlorperazine with, for example, Dronedarone, Ibutilide, Nilotinib. The full list is on the Prochlorperazine page.
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