Drug interactions
Ketoconazole + Repaglinide
Severity: Moderate
Ketoconazole and Repaglinide: 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 repaglinide concentrations, which may cause prolonged or severe hypoglycemia.
What this interaction means in plain words
Ketoconazole and Repaglinide 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; Repaglinide belongs to Endocrine.
Why it happens
Inhibition of CYP3A4 (and possibly OATP1B1) reduces repaglinide clearance.
What to do
Monitor blood glucose closely and reduce the repaglinide dose if needed, or use an alternative antidiabetic. Warn the patient about hypoglycemia symptoms.
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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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 Repaglinide
- Gemfibrozil + Repaglinide Contraindicated
- Clarithromycin + Repaglinide Major
- Clopidogrel + Repaglinide Major
- Cobicistat + Repaglinide Major
- Cyclosporine + Repaglinide Major
- Cyclosporin + Repaglinide Major
Frequently asked questions
Can I take Ketoconazole with Repaglinide?
MediHelp rates the interaction as moderate. Ketoconazole and Repaglinide 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 repaglinide concentrations, which may cause prolonged or severe hypoglycemia.
How serious is the interaction between Ketoconazole and Repaglinide?
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 blood glucose closely and reduce the repaglinide dose if needed, or use an alternative antidiabetic. Warn the patient about hypoglycemia symptoms.
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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