Drug interactions
Ketoconazole + Vilazodone
Severity: Moderate
Ketoconazole and Vilazodone: 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 vilazodone exposure, raising the risk of serotonergic adverse effects such as nausea, diarrhea, and serotonin syndrome. The increase is moderate rather than dramatic.
What this interaction means in plain words
Ketoconazole and Vilazodone 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; Vilazodone belongs to Central Nervous System.
Why it happens
Strong CYP3A4 inhibition reduces vilazodone metabolism.
What to do
Limit vilazodone to 20 mg daily during strong CYP3A4 inhibitor use and monitor for serotonergic effects. Return to the usual dose after ketoconazole is stopped.
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 Vilazodone
- Isocarboxazid + Vilazodone Contraindicated
- Methylene blue + Vilazodone Contraindicated
- Phenelzine + Vilazodone Contraindicated
- Rasagiline + Vilazodone Contraindicated
- Selegiline transdermal + Vilazodone Contraindicated
- Selegiline + Vilazodone Contraindicated
Frequently asked questions
Can I take Ketoconazole with Vilazodone?
MediHelp rates the interaction as moderate. Ketoconazole and Vilazodone 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 vilazodone exposure, raising the risk of serotonergic adverse effects such as nausea, diarrhea, and serotonin syndrome. The increase is moderate rather than dramatic.
How serious is the interaction between Ketoconazole and Vilazodone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit vilazodone to 20 mg daily during strong CYP3A4 inhibitor use and monitor for serotonergic effects. Return to the usual dose after ketoconazole is stopped.
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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