Drug interactions
Ketoconazole + Upadacitinib
Severity: Moderate
Ketoconazole and Upadacitinib: 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 increases upadacitinib exposure, which may heighten the risk of infection and other dose-related adverse effects. Labeling advises dose reduction with strong CYP3A4 inhibitors.
What this interaction means in plain words
Ketoconazole and Upadacitinib 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; Upadacitinib belongs to Musculoskeletal.
Why it happens
Ketoconazole strongly inhibits CYP3A4, the main enzyme metabolizing upadacitinib.
What to do
Use the reduced upadacitinib dose recommended in labeling for strong CYP3A4 inhibitors. Monitor for infections and cytopenias.
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 Upadacitinib
- Abrocitinib + Upadacitinib Contraindicated
- Adenovirus types 4 and 7 live + Upadacitinib Contraindicated
- Baricitinib + Upadacitinib Contraindicated
- Bcg vaccine live + Upadacitinib Contraindicated
- Cyclosporine + Upadacitinib Contraindicated
- Dengue vaccine + Upadacitinib Contraindicated
Frequently asked questions
Can I take Ketoconazole with Upadacitinib?
MediHelp rates the interaction as moderate. Ketoconazole and Upadacitinib 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 increases upadacitinib exposure, which may heighten the risk of infection and other dose-related adverse effects. Labeling advises dose reduction with strong CYP3A4 inhibitors.
How serious is the interaction between Ketoconazole and Upadacitinib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the reduced upadacitinib dose recommended in labeling for strong CYP3A4 inhibitors. Monitor for infections and cytopenias.
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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