Drug Interaction Report

Ketoconazole may increase the blood levels of ado-trastuzumab emtansine. This can increase the risk and/or severity of side effects such as liver impairment, heart failure, nerve damage, and bleeding problems. You may not be able to take ado-trastuzumab emtansine during treatment with ketoconazole, or you may need a dose adjustment and/or more frequent monitoring by your doctor to safely use both medications. Your doctor may also be able to prescribe alternatives that do not interact. You should contact your doctor if you experience shortness of breath, coughing, swelling of the legs or ankles, sudden weight gain, palpitations, dizziness or loss of consciousness, as these may be early symptoms of heart failure. You should also seek immediate medical attention if you develop signs and symptoms of liver damage such as fever, chills, 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. 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.

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.