What the FDA labels say about taking them together
Alprazolam and ketoconazole
Alprazolam's FDA label of January 18, 2023 names ketoconazole in its contraindications section; the ketoconazole label PlainMeds reads does not name alprazolam. The alprazolam label: “• taking strong cytochrome P450 3A (CYP3A) inhibitors, except ritonavir Known hypersensitivity to alprazolam or other benzodiazepines.”
Check it at the source: the alprazolam FDA label on DailyMed (effective January 18, 2023, PHARMACIA & UPJOHN COMPANY LLC); the ketoconazole FDA label on DailyMed (effective January 28, 2026, E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC).
What does the alprazolam label say about ketoconazole?
Alprazolam label, contraindications• taking strong cytochrome P450 3A (CYP3A) inhibitors (e.g., ketoconazole, itraconazole), except ritonavir [see Dosage and Administration (2.6), Warnings and Precautions (5.5), Drug Interactions (7.1) ] Known hypersensitivity to alprazolam or other benzodiazepines.
Alprazolam label, drug interactionsExamples; Ketoconazole, itraconazole, clarithromycin
Alprazolam label, warnings and precautionsKetoconazole and itraconazole have been shown in vivo to increase plasma alprazolam concentrations 3.98 fold and 2.70 fold, respectively.
Alprazolam Xr label (Mylan Pharmaceuticals Inc., February 11, 2025), contraindications• taking strong cytochrome P450 3A (CYP3A) inhibitors (e.g., ketoconazole, itraconazole), except ritonavir [see Dosage and Administration (2.5), Warnings and Precautions (5.5), Drug Interactions (7.1) ]. Known hypersensitivity to alprazolam or other benzodiazepines.
Source: FDA drug label (Alprazolam Xr, NDA021434), Mylan Pharmaceuticals Inc., effective February 11, 2025 (SPL set 1338d1c9-7c75-42ed-95f3-9eb1b6fc51d3), via openFDA
Source: FDA drug label (Xanax), PHARMACIA & UPJOHN COMPANY LLC, effective January 18, 2023 (SPL set 388e249d-b9b6-44c3-9f8f-880eced0239f), via openFDA; the full label on DailyMed
What does the ketoconazole label say about alprazolam?
Ketoconazole's label (effective January 28, 2026) does not name alprazolam in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (ketoconazole), E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC, effective January 28, 2026 (SPL set cad7c647-34a9-4e4e-83b3-8d78e58f588f), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Alprazolam | Ketoconazole | |
|---|---|---|
| Labeled for | Anxiety | Fungal infections |
| Boxed warning | Yes | No |
| Pharmacy cost (NADAC) | $0.0236 per tablet 0.25 mg tablet | $0.249 per gram 2% cream |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once