Drug interactions
Ketoconazole + Sodium bicarbonate
Severity: Moderate
Ketoconazole and Sodium bicarbonate: 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 needs an acidic stomach to dissolve, so oral sodium bicarbonate can reduce its absorption and lead to treatment failure.
What this interaction means in plain words
Ketoconazole and Sodium bicarbonate 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; Sodium bicarbonate belongs to Gastrointestinal Tract.
Why it happens
Raised gastric pH reduces dissolution and absorption of ketoconazole.
What to do
Give ketoconazole at least 1 to 2 hours before the antacid, or consider an alternative antifungal that does not need gastric acid.
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 Sodium bicarbonate
- Acetylsalicylic acid + Sodium bicarbonate Moderate
- Alendronate + Sodium bicarbonate Moderate
- Amantadine + Sodium bicarbonate Moderate
- Carbonyl iron + Sodium bicarbonate Moderate
- Cefditoren + Sodium bicarbonate Moderate
- Cefpodoxime + Sodium bicarbonate Moderate
Frequently asked questions
Can I take Ketoconazole with Sodium bicarbonate?
MediHelp rates the interaction as moderate. Ketoconazole and Sodium bicarbonate 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 needs an acidic stomach to dissolve, so oral sodium bicarbonate can reduce its absorption and lead to treatment failure.
How serious is the interaction between Ketoconazole and Sodium bicarbonate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Give ketoconazole at least 1 to 2 hours before the antacid, or consider an alternative antifungal that does not need gastric acid.
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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