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alprazolam vs ketoconazole

Side-by-side comparison of alprazolam and ketoconazole. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

moderate Known Drug Interaction

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) ].

Recommendation: Your doctor may need to adjust your dose or monitor you more closely for signs of extra sleepiness.

Drug Class
alprazolam Benzodiazepine
ketoconazole Azole Antifungal
Type
alprazolam Prescription
ketoconazole Over-the-Counter
Summary
alprazolam

Alprazolam (Xanax) is a medication that can help you with anxiety and panic disorders. It belongs to a class of drugs called benzodiazepines, which work by slowing down activity in the brain.

ketoconazole

Ketoconazole shampoo is an antifungal medicine. It treats a fungal infection on your skin.

What It Treats
alprazolam

Alprazolam is used to treat generalized anxiety disorder (GAD) and panic disorder (PD) in adults. GAD involves excessive worry and tension, while PD causes sudden and intense episodes of fear. This medicine can help reduce these symptoms.

ketoconazole

This shampoo treats tinea versicolor, a fungal infection. This infection can cause patches on your skin that are lighter or darker than the surrounding skin. These patches may appear on your trunk, neck, arms, and upper thighs.

How It Works
alprazolam

Alprazolam works by affecting certain chemicals in your brain called neurotransmitters. It enhances the effects of a neurotransmitter called GABA, which helps to calm your nerves. This can reduce feelings of anxiety and panic.

ketoconazole

Ketoconazole is an antifungal medicine. It works by stopping the growth of the fungus. This helps to clear up the infection.

Common Side Effects
alprazolam
  • Drowsiness
  • Light-headedness
  • Dry mouth
ketoconazole

No common side effects listed.

FAERS Reports
alprazolam
  • Feeling sick to your stomach 12,854
  • Feeling tired 11,935
  • Misusing the drug 10,943
  • Feeling worried or nervous 10,169
  • Pain in your head 9,923
ketoconazole
  • Feeling tired 929
  • Itching 902
  • Feeling sick to your stomach 834
  • Skin breakout 802
  • Loose stool 760
Serious Warnings
alprazolam

Alprazolam can be habit-forming, leading to abuse, misuse, and addiction, which can result in overdose or death. Taking alprazolam with opioid pain medicines can cause severe sleepiness, breathing problems, coma, and death. Suddenly stopping alprazolam can cause life-threatening withdrawal symptoms. Talk to your doctor about how to safely stop taking it.

ketoconazole

You should not use this shampoo if you are allergic to ketoconazole or any of the other ingredients.

Pregnancy
alprazolam

Taking alprazolam late in pregnancy can cause sedation or withdrawal symptoms in the newborn. Breastfeeding is not recommended while taking alprazolam because it can cause sedation and feeding problems in the baby.

ketoconazole

It is not known if ketoconazole shampoo can harm an unborn baby. Talk to your doctor if you are pregnant or breastfeeding before using this medicine.

Also Compare, Nearby Drugs

How to Read This alprazolam vs ketoconazole Comparison

alprazolam is classified in the Benzodiazepine drug class, while ketoconazole sits within the Azole Antifungal class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are split between OTC and prescription status, which affects access and supervision.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, alprazolam has 55,824 submissions while ketoconazole has 4,227. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known moderate interaction flagged in FDA labeling, attributed to ketoconazole stops the body from breaking down alprazolam normally, which can increase the risk of side effects.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between alprazolam and ketoconazole - always consult your physician or pharmacist first.

Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.