Drug interactions
Ketoconazole + Tolazamide
Severity: Moderate
Ketoconazole and Tolazamide: 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 may raise tolazamide exposure and strengthen its glucose-lowering effect. This can lead to hypoglycemia, particularly in older patients or those with reduced renal function. Azole antifungals are known to potentiate sulfonylureas.
What this interaction means in plain words
Ketoconazole and Tolazamide 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; Tolazamide belongs to Endocrine.
Why it happens
Ketoconazole inhibits hepatic CYP-mediated metabolism of the sulfonylurea, increasing its plasma concentrations.
What to do
Monitor blood glucose closely when starting or stopping ketoconazole and educate the patient on hypoglycemia symptoms. Reduce the tolazamide dose if glucose falls.
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 Tolazamide
- Disopyramide + Tolazamide Major
- Insulin degludec-liraglutide + Tolazamide Major
- Aceclofenac + Tolazamide Moderate
- Acemetacin + Tolazamide Moderate
- Acetylsalicylic acid + Tolazamide Moderate
- Albiglutide + Tolazamide Moderate
Frequently asked questions
Can I take Ketoconazole with Tolazamide?
MediHelp rates the interaction as moderate. Ketoconazole and Tolazamide 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 may raise tolazamide exposure and strengthen its glucose-lowering effect. This can lead to hypoglycemia, particularly in older patients or those with reduced renal function. Azole antifungals are known to potentiate sulfonylureas.
How serious is the interaction between Ketoconazole and Tolazamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose closely when starting or stopping ketoconazole and educate the patient on hypoglycemia symptoms. Reduce the tolazamide dose if glucose falls.
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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