Drug interactions
Ketoconazole + Umeclidinium bromide / vilanterol inhaled
Severity: Moderate
Ketoconazole and Umeclidinium bromide / vilanterol inhaled: 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 can increase systemic vilanterol exposure, which may enhance beta-agonist effects such as tachycardia, tremor and hypokalemia. Cardiovascular effects, including QT prolongation, are the main concern.
What this interaction means in plain words
Ketoconazole and Umeclidinium bromide / vilanterol inhaled 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.
Why it happens
Strong CYP3A4 inhibition reduces vilanterol metabolism and raises its systemic levels.
What to do
Monitor heart rate, ECG and potassium, and for beta-agonist adverse effects. Use caution in patients with cardiovascular disease or consider an alternative bronchodilator.
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
Frequently asked questions
Can I take Ketoconazole with Umeclidinium bromide / vilanterol inhaled?
MediHelp rates the interaction as moderate. Ketoconazole and Umeclidinium bromide / vilanterol inhaled 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 can increase systemic vilanterol exposure, which may enhance beta-agonist effects such as tachycardia, tremor and hypokalemia. Cardiovascular effects, including QT prolongation, are the main concern.
How serious is the interaction between Ketoconazole and Umeclidinium bromide / vilanterol inhaled?
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 heart rate, ECG and potassium, and for beta-agonist adverse effects. Use caution in patients with cardiovascular disease or consider an alternative bronchodilator.
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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