Drug interactions
Ketoconazole + Repotrectinib
Severity: Major
Ketoconazole and Repotrectinib: 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 substantially increases repotrectinib exposure, which could worsen neurologic effects such as dizziness and ataxia, as well as hepatotoxicity and other toxicities.
What this interaction means in plain words
Ketoconazole and Repotrectinib 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; Repotrectinib belongs to Oncology.
Why it happens
Inhibition of CYP3A4 metabolism and P-glycoprotein efflux of repotrectinib.
What to do
Avoid strong CYP3A4 and P-gp inhibitors with repotrectinib and choose an alternative antifungal; monitor for neurologic toxicity if unavoidable.
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 Repotrectinib
- Apalutamide + Repotrectinib Contraindicated
- Amiodarone + Repotrectinib Major
- Amobarbital + Repotrectinib Major
- Aprepitant + Repotrectinib Major
- Armodafinil + Repotrectinib Major
- Bosentan + Repotrectinib Major
Frequently asked questions
Can I take Ketoconazole with Repotrectinib?
MediHelp rates the interaction as major. Ketoconazole and Repotrectinib 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 substantially increases repotrectinib exposure, which could worsen neurologic effects such as dizziness and ataxia, as well as hepatotoxicity and other toxicities.
How serious is the interaction between Ketoconazole and Repotrectinib?
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 strong CYP3A4 and P-gp inhibitors with repotrectinib and choose an alternative antifungal; monitor for neurologic toxicity if unavoidable.
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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