Does Ketoconazole Interact With Tramadol?

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. Ketoconazole is a azole antifungal (strong cyp3a4 inhibitor) and Tramadol is a opioid analgesic; 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 Ketoconazole and Tramadol, 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.

ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of tramadol hydrochloride extended-release tablets and CYP3A4 inducers can decrease the plasma concentration of tramadol [see Clinical Pharmacology ( 12.3 )] , resulting in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence to tramadol, [see Warnings and Precautions ( 5.

Source: FDA structured product labeling (set_id 004de5a4-80f8-4040-a6ea-be5e99352a36).