Drug interactions
Ketoconazole + Rilpivirine
Severity: Moderate
Ketoconazole and Rilpivirine: 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 raises rilpivirine concentrations and rilpivirine may modestly lower ketoconazole exposure. Higher rilpivirine levels carry a QT-prolongation concern and lower azole levels could reduce antifungal efficacy.
What this interaction means in plain words
Ketoconazole and Rilpivirine 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; Rilpivirine belongs to Anti Virals.
Why it happens
Ketoconazole inhibits CYP3A4 metabolism of rilpivirine, while rilpivirine may slightly reduce ketoconazole concentrations.
What to do
No rilpivirine dose adjustment is needed; monitor for breakthrough fungal infection and consider ECG monitoring if other QT-prolonging drugs are used.
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 Rilpivirine
- Carbamazepine + Rilpivirine Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexlansoprazole + Rilpivirine Contraindicated
- Efavirenz + Rilpivirine Contraindicated
- Eslicarbazepine + Rilpivirine Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
Frequently asked questions
Can I take Ketoconazole with Rilpivirine?
MediHelp rates the interaction as moderate. Ketoconazole and Rilpivirine 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 raises rilpivirine concentrations and rilpivirine may modestly lower ketoconazole exposure. Higher rilpivirine levels carry a QT-prolongation concern and lower azole levels could reduce antifungal efficacy.
How serious is the interaction between Ketoconazole and Rilpivirine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No rilpivirine dose adjustment is needed; monitor for breakthrough fungal infection and consider ECG monitoring if other QT-prolonging drugs are used.
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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