Alprazolam and Ketoconazole Interaction
Drug interaction information between Alprazolam and Ketoconazole.
Alprazolam and Ketoconazole have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Alprazolam and Ketoconazole. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.
How They Interact
Ketoconazole stops the body from breaking down alprazolam normally, which can increase the risk of side effects.
FDA Label Information
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) ].
Alprazolam Also Interacts With
- Clarithromycin moderate
- Itraconazole moderate
- Digoxin moderate
- Aprepitant moderate
- Fluoxetine moderate
Ketoconazole Also Interacts With
- Alfuzosin major
- Dronedarone major
- Ranolazine major
- Saxagliptin major
- Sildenafil major
Frequently Asked Questions
What SPL severity band is on file for Alprazolam + Ketoconazole?
Compiled FDA labeling labels this pair moderate. That is a source-record field, not an individual medication-combination decision.
Which drug in this pair has the larger labeled-interaction portfolio?
Ketoconazole has 113 labeled pairs on file vs Alprazolam's 27. In the moderate band specifically: Alprazolam has 7 (also Clarithromycin, Itraconazole, Digoxin, Aprepitant); Ketoconazole has 22 (also Aprepitant, Budesonide/Formoterol, Dexamethasone, Fesoterodine).
What mechanism field is on file for Alprazolam and Ketoconazole?
Ketoconazole stops the body from breaking down alprazolam normally, which can increase the risk of side effects.
Ketoconazole carries more major-labeled pairs than Alprazolam
SPL source-record counts only. This page's band is moderate · classes on file: Alprazolam (Benzodiazepine); Ketoconazole (Azole Antifungal).
Ketoconazole has 6 major-labeled pairs vs Alprazolam's 0. This page itself is in the moderate band, not the major band.
0 major · 7 moderate · 20 minor · 27 total
- Other moderate peers for Alprazolam
- Clarithromycin
- Itraconazole
- Digoxin
- Aprepitant
6 major · 22 moderate · 85 minor · 113 total
- Other moderate peers for Ketoconazole
- Aprepitant
- Budesonide/Formoterol
- Dexamethasone
- Fesoterodine
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.
Read our methodology - how this data is sourced, computed, and verified.