Drug interactions
Ketoconazole + Vonoprazan
Severity: Moderate
Ketoconazole and Vonoprazan: 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 needs gastric acid for dissolution and absorption. Vonoprazan strongly suppresses acid, so ketoconazole absorption and antifungal effect may decrease.
What this interaction means in plain words
Ketoconazole and Vonoprazan 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; Vonoprazan belongs to Gastrointestinal Tract.
Why it happens
Raised gastric pH reduces dissolution and absorption of oral ketoconazole.
What to do
Give ketoconazole at least 1 hour before or 2 hours after vonoprazan. Consider an alternative antifungal or monitor response if acid suppression is required.
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 Vonoprazan
- Amobarbital + Vonoprazan Major
- Apalutamide + Vonoprazan Major
- Atazanavir + Vonoprazan Major
- Carbamazepine + Vonoprazan Major
- Erlotinib + Vonoprazan Major
- Phenytoin + Vonoprazan Major
Frequently asked questions
Can I take Ketoconazole with Vonoprazan?
MediHelp rates the interaction as moderate. Ketoconazole and Vonoprazan 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 needs gastric acid for dissolution and absorption. Vonoprazan strongly suppresses acid, so ketoconazole absorption and antifungal effect may decrease.
How serious is the interaction between Ketoconazole and Vonoprazan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Give ketoconazole at least 1 hour before or 2 hours after vonoprazan. Consider an alternative antifungal or monitor response if acid suppression is required.
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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