Drug interactions
Ketoconazole + Vincristine liposomal
Severity: Major
Ketoconazole and Vincristine liposomal: major 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 inhibits vincristine metabolism and efflux and can increase vincristine toxicity, especially neurotoxicity and constipation or ileus. Severe neuropathy has been reported with azoles.
What this interaction means in plain words
Ketoconazole and Vincristine liposomal can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein reduces vincristine clearance.
What to do
Avoid concurrent use where possible and choose a non-CYP3A4-inhibiting antifungal; otherwise monitor closely for neurotoxicity and constipation.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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 Vincristine liposomal?
MediHelp rates the interaction as major. Ketoconazole and Vincristine liposomal can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ketoconazole inhibits vincristine metabolism and efflux and can increase vincristine toxicity, especially neurotoxicity and constipation or ileus. Severe neuropathy has been reported with azoles.
How serious is the interaction between Ketoconazole and Vincristine liposomal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use where possible and choose a non-CYP3A4-inhibiting antifungal; otherwise monitor closely for neurotoxicity and constipation.
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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