Does Butalbital Aspirin Caffeine And Codeine Phosphate Interact with Ketoconazole?
Butalbital Aspirin Caffeine And Codeine Phosphate and Ketoconazole have a major drug interaction according to U.S. FDA drug labeling data. CYP3A4 inhibitor may increase codeine plasma concentrations and morphine levels, potentially causing fatal respiratory depression, particularly when added after stable dosing. The mechanism involves inhibition of cyp3a4 leads to increased codeine metabolism by cyp2d6, resulting in greater morphine levels. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.
- Severity
- Major
- Butalbital Aspirin Caffeine And Codeine Phosphate Class
- Nonsteroidal Anti-inflammatory Drug
- Ketoconazole Class
- Azole Antifungal
- Management
- Close medical supervision required
- Data Source
- U.S. FDA via OpenFDA
How This Interaction Works
The interaction between Butalbital Aspirin Caffeine And Codeine Phosphate and Ketoconazole occurs because inhibition of cyp3a4 leads to increased codeine metabolism by cyp2d6, resulting in greater morphine levels. Clinically, this means cyp3a4 inhibitor may increase codeine plasma concentrations and morphine levels, potentially causing fatal respiratory depression, particularly when added after stable dosing. This is classified as a major interaction, meaning it could cause serious harm if not properly managed. Your healthcare provider may need to adjust dosages, substitute one medication, or increase monitoring frequency.
What To Tell Your Doctor or Pharmacist
If you are taking Butalbital Aspirin Caffeine And Codeine Phosphate and your doctor is considering prescribing Ketoconazole (or vice versa), make sure to:
- Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
- Ask whether the benefits of combining these medications outweigh the risks for your specific situation
- Ask what symptoms to watch for that would indicate the interaction is causing problems
- Ask how frequently you should be monitored while these are co-prescribed
- Ask whether any dosage adjustments are needed
- Never stop or change either medication without first consulting your healthcare provider