Does Hydrocodone Acetaminophen Interact With Ketoconazole?

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

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. Hydrocodone Acetaminophen is a opioid analgesic combination 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 have been prescribed both Hydrocodone Acetaminophen 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.

Risks of Concomitant Use or Discontinuation of Cytochrome P450 3A4 Inhibitors and Inducers Concomitant use of hydrocodone bitartrate and acetaminophen tablets with a CYP3A4 inhibitor, such as macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g., ketoconazole), and protease inhibitors (e.g., ritonavir), may increase plasma concentrations of hydrocodone bitartrate and acetaminophen tablets and prolong opioid adverse reactions, and which may cause potentially fatal respirato…

Source: FDA structured product labeling (set_id ee248dfd-7aa7-7dcc-e053-2995a90af19f).