Does Ketoconazole Interact with Prasugrel?
Ketoconazole and Prasugrel have a minor drug interaction according to U.S. FDA drug labeling data. Selective CYP3A4/3A5 inhibitor decreased Cmax by 34-46% but did not affect platelet aggregation inhibition or AUC/Tmax. The mechanism involves cyp3a inhibition. 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
- Minor
- Ketoconazole Class
- Azole Antifungal
- Management
- Generally manageable
- Data Source
- U.S. FDA via OpenFDA
How This Interaction Works
The interaction between Ketoconazole and Prasugrel occurs because cyp3a inhibition. Clinically, this means selective cyp3a4/3a5 inhibitor decreased cmax by 34-46% but did not affect platelet aggregation inhibition or auc/tmax. This is classified as a minor interaction with generally low clinical significance, though your healthcare provider should still be informed that you are taking both medications.
What To Tell Your Doctor or Pharmacist
If you are taking Ketoconazole and your doctor is considering prescribing Prasugrel (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
- Never stop or change either medication without first consulting your healthcare provider