Drug interactions
Ketoconazole + Sonidegib
Severity: Major
Ketoconazole and Sonidegib: 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 markedly raises sonidegib exposure, which may increase the risk of musculoskeletal toxicity including rhabdomyolysis, and other adverse effects.
What this interaction means in plain words
Ketoconazole and Sonidegib 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; Sonidegib belongs to Oncology.
Why it happens
Strong inhibition of CYP3A4-mediated metabolism of sonidegib.
What to do
Avoid strong CYP3A4 inhibitors; if short-term use is unavoidable, monitor serum creatine kinase and muscle symptoms frequently.
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 Sonidegib
- Amiodarone + Sonidegib Major
- Apalutamide + Sonidegib Major
- Aprepitant + Sonidegib Major
- Armodafinil + Sonidegib Major
- Bosentan + Sonidegib Major
- Carbamazepine + Sonidegib Major
Frequently asked questions
Can I take Ketoconazole with Sonidegib?
MediHelp rates the interaction as major. Ketoconazole and Sonidegib 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 markedly raises sonidegib exposure, which may increase the risk of musculoskeletal toxicity including rhabdomyolysis, and other adverse effects.
How serious is the interaction between Ketoconazole and Sonidegib?
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 inhibitors; if short-term use is unavoidable, monitor serum creatine kinase and muscle symptoms frequently.
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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