Drug interactions
Ketoconazole + Sufentanil sl
Severity: Major
Ketoconazole and Sufentanil sl: 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 is a strong CYP3A4 inhibitor and can raise sufentanil exposure. This may cause deeper sedation and potentially life-threatening respiratory depression. Stopping the inhibitor later can lower opioid levels and reduce effect.
What this interaction means in plain words
Ketoconazole and Sufentanil sl 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
Strong inhibition of CYP3A4-mediated sufentanil metabolism increases systemic sufentanil concentrations.
What to do
Monitor closely for respiratory depression and sedation and consider reducing the sufentanil dose or choosing an alternative. If ketoconazole is stopped, watch for reduced analgesia or withdrawal and readjust the dose.
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 Sufentanil sl?
MediHelp rates the interaction as major. Ketoconazole and Sufentanil sl 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 is a strong CYP3A4 inhibitor and can raise sufentanil exposure. This may cause deeper sedation and potentially life-threatening respiratory depression. Stopping the inhibitor later can lower opioid levels and reduce effect.
How serious is the interaction between Ketoconazole and Sufentanil sl?
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 closely for respiratory depression and sedation and consider reducing the sufentanil dose or choosing an alternative. If ketoconazole is stopped, watch for reduced analgesia or withdrawal and readjust the dose.
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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