Can you take Ketoconazole with Treosulfan?
1 drug interaction and 8 additional warnings found for the following 2 drugs:
- ketoconazole
- treosulfan
Drug interactions
Moderate drug interactions
Moderate:
ketoconazole treosulfan
Applies to: ketoconazole and treosulfan
Treosulfan may increase the blood levels and effects of ketoconazole.
Contact your doctor if your condition changes during treatment with these medications. You may need a dose adjustment or more frequent monitoring to safely use both medications.
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/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
ketoconazole Food/Lifestyle
Applies to: ketoconazole
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
- 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.
Disease interactions
7 potential interactions Applies to: 6 conditions, including Seizures, Arrhythmia, Adrenal Insufficiency, Liver Disease, and Renal Dysfunction.
Achlorhydria
Moderate:
ketoconazole
Ketoconazole has a moderate potential interaction with Achlorhydria.
Nizoral (brand of ketoconazole) tablets require acidity for proper dissolution and absorption. Therefore, the drug may not be effective in patients with achlorhydria. Taking the medication with an acidic beverage such as orange or cranberry juice may help, but an alternative antifungal agent should be considered.
Adrenal Insufficiency
Moderate:
ketoconazole
Ketoconazole has a moderate potential interaction with Adrenal Insufficiency.
Ketoconazole tablets decrease adrenal corticosteroid secretion at doses of 400 mg and higher. Adrenal function should be monitored in patients with adrenal insufficiency or with borderline adrenal function and in patients with prolonged periods of stress due to major surgery, intensive care, etc.
Arrhythmia
Moderate:
ketoconazole
Ketoconazole has a moderate potential interaction with Arrhythmia.
Some azole antifungals have been associated with prolongation of the QT interval on the ECG. Rare cases of QT prolongation and torsade de pointes have been reported during postmarketing experience; such reports usually involved seriously ill patients with multiple confounding risk factors, such as structural heart disease, electrolyte abnormalities, and concomitant medications. These drugs should be administered with caution to patients with potentially proarrhythmic conditions, such as congenital/acquired QT prolongation, cardiomyopathy (especially when heart failure is present), sinus bradycardia, and existing symptomatic arrhythmias. Concomitant use with other medications that have potential to increase the risk of cardiotoxicity should be avoided.
Liver Disease
Major:
ketoconazole
Ketoconazole has a major potential interaction with Liver Disease.
Serious hepatotoxicity including cases with a fatal outcome or requiring liver transplant have been reported. Some patients had no obvious risk factors for liver disease. Liver function tests should be performed prior to initiation of therapy and regularly during treatment in patients receiving prolonged therapy with ketoconazole, particularly those with a current or past history of liver disease. Therapy should be withdrawn if persistent elevations or worsening of liver enzyme levels occur, or if the abnormalities are accompanied by symptoms of possible liver injury. Since ketoconazole is primarily metabolized by the liver, empirically reducing the dosage may also be appropriate in patients with existing liver disease. The use of oral ketoconazole tablets is contraindicated in patients with acute or chronic liver disease.
Moderate:
treosulfan
Treosulfan has a moderate potential interaction with Liver Disease.
Treosulfan has not been studied in patients with moderate or severe liver and renal dysfunction.
Renal Dysfunction
Moderate:
treosulfan
Treosulfan has a moderate potential interaction with Renal Dysfunction.
Treosulfan has not been studied in patients with moderate or severe liver and renal dysfunction.
Seizures
Moderate:
treosulfan
Treosulfan has a moderate potential interaction with Seizures.
There have been reports of seizures in patients following treatment with treosulfan. Patients should be monitored for signs of neurological adverse reactions, and clonazepam prophylaxis may be considered for patients at higher risk for seizures, including infants.
More resources
ketoconazole
A total of 904 drugs are known to interact with ketoconazole.
- Ketoconazole is in the drug class azole antifungals.
-
Ketoconazole is used to treat the following conditions:
- Blastomycosis
- Chromomycosis
- Chronic Mucocutaneous Candidiasis (off-label)
- Coccidioidomycosis
- Dermatophytosis (off-label)
- Esophageal Candidiasis (off-label)
- Histoplasmosis
- Onychomycosis, Fingernail (off-label)
- Onychomycosis, Toenail (off-label)
- Oral Thrush (off-label)
- Paracoccidioidomycosis
- Tinea Corporis (off-label)
- Tinea Versicolor (off-label)
- Vaginal Yeast Infection (off-label)
treosulfan
A total of 547 drugs are known to interact with treosulfan.
- Treosulfan is in the drug class alkylating agents.
- Treosulfan is used to treat Stem Cell Transplant Conditioning.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.