Drug interactions
Ketoconazole + Zonisamide
Severity: Moderate
Ketoconazole and Zonisamide: 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 may raise zonisamide concentrations, potentially increasing somnolence, dizziness, and other dose-related adverse effects.
What this interaction means in plain words
Ketoconazole and Zonisamide 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; Zonisamide belongs to Central Nervous System.
Why it happens
Ketoconazole inhibits CYP3A4, which contributes to zonisamide metabolism.
What to do
Monitor for sedation, cognitive effects, and metabolic acidosis, and reduce zonisamide dose if adverse effects arise.
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 Zonisamide
- Zonisamide + Zuranolone Major
- Acetazolamide + Zonisamide Moderate
- Amisulpride + Zonisamide Moderate
- Amobarbital + Zonisamide Moderate
- Apalutamide + Zonisamide Moderate
- Asenapine transdermal + Zonisamide Moderate
Frequently asked questions
Can I take Ketoconazole with Zonisamide?
MediHelp rates the interaction as moderate. Ketoconazole and Zonisamide 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 may raise zonisamide concentrations, potentially increasing somnolence, dizziness, and other dose-related adverse effects.
How serious is the interaction between Ketoconazole and Zonisamide?
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 for sedation, cognitive effects, and metabolic acidosis, and reduce zonisamide dose if adverse effects arise.
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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