Does Alprazolam Interact With Ketoconazole?

Examples Ketoconazole, itraconazole, clarithromycin Moderate or Weak Inhibitors of CYP3A Clinical implication Concomitant use of alprazolam with CYP3A inhibitors may increase the concentrations of alprazolam, resulting in increased risk of adverse reactions of alprazolam [see Clinical Pharmacology (12.3) ].

Severity: Moderate

Severity basis: drug interactions section (keywords: increased risk, may increase). Combining Alprazolam (Benzodiazepine) and Ketoconazole (Azole antifungal (strong CYP3A4 inhibitor)) is classified as a moderate interaction.

What to Do

Use this combination with caution. Your prescriber may monitor you more closely or adjust doses.

From the FDA Label

Examples Ketoconazole, itraconazole, clarithromycin Moderate or Weak Inhibitors of CYP3A Clinical implication Concomitant use of alprazolam with CYP3A inhibitors may increase the concentrations of alprazolam, resulting in increased risk of adverse reactions of alprazolam [see Clinical Pharmacology (12.3) ].

Source: FDA structured product labeling (set_id 02840ea6-e4a0-96a0-e063-6394a90a19ae).

Alprazolam

Benzodiazepine

Brands: Xanax

View Alprazolam safety profile

Ketoconazole

Azole antifungal (strong CYP3A4 inhibitor)

Brands: Nizoral

View Ketoconazole safety profile

Check these against your full medication list in our free Interaction Checker

This information is educational — not medical advice.

This page is provided for general educational purposes and summarizes publicly available data from sources such as the U.S. Food & Drug Administration. It is not a substitute for the judgment of a licensed clinician and should not be used to start, stop, or change any medication. It may be incomplete or out of date, and individual circumstances vary. Always talk with your prescriber or pharmacist about your specific medications and health conditions. If you think you may have a medical emergency, call 911.

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