Does Eszopiclone Interact With Ketoconazole?

Name: Does Eszopiclone Interact With Ketoconazole?
Creator: OmniRx Health

Use with ethanol causes additive psychomotor impairment ( 7.1 ) • Rifampicin Combination use may decrease exposure and effects of eszopiclone tablets ( 7.2 ) • Ketoconazole Combination use increases exposure and effect of eszopiclone tablets.

Reviewed by the OmniRx Health clinical team•Last reviewed Jul 4, 2026

Severity: Moderate

Severity basis: drug interactions section (keywords: may decrease). Combining Eszopiclone (Sedative-hypnotic (Z-drug)) 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.

How This Interaction Works

Interactions like this one can happen when two medicines have overlapping effects, or when one changes how the other is absorbed, broken down, or cleared from the body. Eszopiclone is a sedative-hypnotic (z-drug) and Ketoconazole is a azole antifungal (strong cyp3a4 inhibitor); together they are documented as a moderate interaction. How much this matters depends on your dose, your other medications, and your overall health.

If You Take Both Medications

If you have been prescribed both Eszopiclone and Ketoconazole, do not start, stop, or change either medication on your own — some medicines are unsafe to stop suddenly. Tell your prescriber and pharmacist that you take both so they can decide whether the combination is right for you, adjust the dose, monitor you more closely, or suggest an alternative.

From the FDA Label

Use with ethanol causes additive psychomotor impairment ( 7.1 ) • Rifampicin Combination use may decrease exposure and effects of eszopiclone tablets ( 7.2 ) • Ketoconazole Combination use increases exposure and effect of eszopiclone tablets.

Source: FDA structured product labeling (set_id 00fc3250-3e29-4a4b-ac0c-74910659337c).

Eszopiclone

Sedative-hypnotic (Z-drug)

Brands: Lunesta

View Eszopiclone 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

Frequently Asked Questions

Can you take Eszopiclone and Ketoconazole together?

Eszopiclone and Ketoconazole have a documented moderate interaction. Use this combination with caution. Your prescriber may monitor you more closely or adjust doses.

How serious is the Eszopiclone and Ketoconazole interaction?

It is classified as a moderate interaction, based on the FDA label's drug interactions section (keywords: may decrease). A moderate interaction can be clinically meaningful and usually calls for monitoring or a dose adjustment.

What should I do if I'm taking both Eszopiclone and Ketoconazole?

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.

Questions About Your Medications?

A licensed OmniRx provider can review your full medication list and help you understand what's safe for you — no office visit required.

Other Eszopiclone Interactions

Other Ketoconazole Interactions

Sources & References

Learn more about where our data comes from and how we write and review medical content.