Drug interactions
Ketoconazole + Tipranavir
Severity: Major
Ketoconazole and Tipranavir: 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
Tipranavir, given with ritonavir, increases ketoconazole concentrations, while ketoconazole may also raise tipranavir exposure. Higher ketoconazole levels increase the risk of hepatotoxicity and QT effects.
What this interaction means in plain words
Ketoconazole and Tipranavir 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; Tipranavir belongs to Anti Virals.
Why it happens
Ritonavir-boosted tipranavir inhibits CYP3A4, increasing ketoconazole levels, and ketoconazole inhibits CYP3A4, increasing tipranavir exposure.
What to do
Keep the ketoconazole dose to no more than 200 mg daily. Monitor liver function and ECG, and for antiretroviral toxicity.
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 Tipranavir
- Alfuzosin + Tipranavir Contraindicated
- Amiodarone + Tipranavir Contraindicated
- Atorvastatin + Tipranavir Contraindicated
- Avanafil + Tipranavir Contraindicated
- Cisapride + Tipranavir Contraindicated
- Colchicine + Tipranavir Contraindicated
Frequently asked questions
Can I take Ketoconazole with Tipranavir?
MediHelp rates the interaction as major. Ketoconazole and Tipranavir 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. Tipranavir, given with ritonavir, increases ketoconazole concentrations, while ketoconazole may also raise tipranavir exposure. Higher ketoconazole levels increase the risk of hepatotoxicity and QT effects.
How serious is the interaction between Ketoconazole and Tipranavir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Keep the ketoconazole dose to no more than 200 mg daily. Monitor liver function and ECG, and for antiretroviral toxicity.
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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