Drug interactions
Ketoconazole + Romidepsin
Severity: Major
Ketoconazole and Romidepsin: 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 can raise romidepsin exposure and both drugs prolong the QT interval. This increases the risk of toxicity including arrhythmia.
What this interaction means in plain words
Ketoconazole and Romidepsin 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.
Why it happens
Ketoconazole inhibits CYP3A4 and P-glycoprotein, increasing romidepsin exposure, with additive QT prolongation.
What to do
Monitor ECG and electrolytes (potassium, magnesium) and for romidepsin toxicity, or use an alternative antifungal.
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
Frequently asked questions
Can I take Ketoconazole with Romidepsin?
MediHelp rates the interaction as major. Ketoconazole and Romidepsin 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 can raise romidepsin exposure and both drugs prolong the QT interval. This increases the risk of toxicity including arrhythmia.
How serious is the interaction between Ketoconazole and Romidepsin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG and electrolytes (potassium, magnesium) and for romidepsin toxicity, or use an alternative antifungal.
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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