Drug interactions
Ketoconazole + Tretinoin
Severity: Moderate
Ketoconazole and Tretinoin: 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 increase systemic exposure to oral tretinoin and its toxicity, such as headache, hypercalcemia, and pseudotumor cerebri. Tretinoin metabolism depends partly on CYP enzymes that azoles inhibit. This applies to oral tretinoin rather than topical use.
What this interaction means in plain words
Ketoconazole and Tretinoin 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; Tretinoin belongs to Dermatology.
Why it happens
Ketoconazole inhibits CYP-mediated oxidative metabolism of tretinoin, raising its plasma levels.
What to do
Monitor for retinoid toxicity (headache, mucocutaneous effects, hypercalcemia, lipids) when oral tretinoin is combined with ketoconazole. Reduce the tretinoin dose if toxicity appears.
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 Tretinoin
- Doxycycline + Tretinoin Major
- Minocycline + Tretinoin Major
- Omadacycline + Tretinoin Major
- Palovarotene + Tretinoin Major
- Sarecycline + Tretinoin Major
- Tetracycline + Tretinoin Major
Frequently asked questions
Can I take Ketoconazole with Tretinoin?
MediHelp rates the interaction as moderate. Ketoconazole and Tretinoin 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 increase systemic exposure to oral tretinoin and its toxicity, such as headache, hypercalcemia, and pseudotumor cerebri. Tretinoin metabolism depends partly on CYP enzymes that azoles inhibit. This applies to oral tretinoin rather than topical use.
How serious is the interaction between Ketoconazole and Tretinoin?
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 for retinoid toxicity (headache, mucocutaneous effects, hypercalcemia, lipids) when oral tretinoin is combined with ketoconazole. Reduce the tretinoin dose if toxicity appears.
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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