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Interactions médicamenteuses

Ketoconazole + Sirolimus

Gravité: Contre-indiquée

Ketoconazole and Sirolimus: contraindicated interaction.

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Résumé

Ketoconazole markedly increases sirolimus blood concentrations, causing a risk of immunosuppressant toxicity such as myelosuppression, hyperlipidemia, infection and impaired wound healing. Labeling advises against the combination.

Ce que signifie cette interaction, en termes simples

Ketoconazole and Sirolimus are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Ketoconazole belongs to Anti Fungals; Sirolimus belongs to Miscellaneous.

Niveau de preuve: High

Pourquoi elle survient

Ketoconazole inhibits CYP3A4 and P-glycoprotein, reducing sirolimus metabolism and efflux.

Conduite à tenir

Avoid concurrent use and choose an alternative antifungal, such as an echinocandin. If unavoidable, reduce the sirolimus dose substantially and monitor trough levels closely.

Questions à poser à votre pharmacien

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Questions fréquentes

Can I take Ketoconazole with Sirolimus?

MediHelp rates the interaction as contraindicated. Ketoconazole and Sirolimus are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ketoconazole markedly increases sirolimus blood concentrations, causing a risk of immunosuppressant toxicity such as myelosuppression, hyperlipidemia, infection and impaired wound healing. Labeling advises against the combination.

How serious is the interaction between Ketoconazole and Sirolimus?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use and choose an alternative antifungal, such as an echinocandin. If unavoidable, reduce the sirolimus dose substantially and monitor trough levels closely.

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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