Drug Interactions between ketoconazole and suvorexant

You should avoid the use of alcohol while being treated with ketoconazole. Ketoconazole may cause liver damage and using it with alcohol or products containing alcohol may increase that risk. In addition, consumption of alcoholic beverages or products containing alcohol during treatment with ketoconazole may trigger a disulfiram-like reaction in some patients, with unpleasant symptoms such as flushing, palpitations, and nausea. Ketoconazole may be taken with or without food. You should avoid consumption of grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with ketoconazole unless directed otherwise by your doctor. Grapefruit juice may increase the blood levels of ketoconazole. This may increase the risk and/or severity of side effects and liver problems. You should seek immediate medical attention if you develop signs and symptoms of liver damage during treatment with ketoconazole, such as joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and yellowing of the skin or eyes. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food can delay the absorption of suvorexant, which may increase the amount of time it takes for the medication to work. For faster sleep onset, do not take suvorexant with or soon after a meal. Suvorexant should also not be taken with grapefruit juice, as it may significantly increase the levels of medication in the blood. This can increase the risk of side effects including excessive drowsiness, motor impairment, amnesia, anxiety, hallucinations, and breathing difficulties (especially if you have a respiratory disorder such as asthma or obstructive sleep apnea). Talk to your doctor if you have any questions or concerns. You should avoid the use of alcohol while being treated with suvorexant. Avoid driving or operating hazardous machinery until you know how the medication affects you, and do not exceed the dosage or frequency of use prescribed by your doctor. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.