Buprenorphine and Ketoconazole Interaction

Drug interaction information between Buprenorphine and Ketoconazole.

Buprenorphine and Ketoconazole have a documented minor interaction in FDA labeling.

FDA drug labeling documents a minor-severity interaction between Buprenorphine 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.

Drug A

Buprenorphine

Partial Opioid Agonist

Drug B

Ketoconazole

Azole Antifungal

How They Interact

Ketoconazole interferes with the enzymes that break down buprenorphine, which can change the amount of medicine that stays in your blood.

FDA Label Information

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

Frequently Asked Questions

What SPL severity band is on file for Buprenorphine + Ketoconazole?

Compiled FDA labeling labels this pair minor. 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 Buprenorphine's 29. In the minor band specifically: Buprenorphine has 28 (also Trazodone, Cyclobenzaprine, Mirtazapine, Carbamazepine); Ketoconazole has 85 (also Abiraterone, Acetaminophen/Oxycodone, Alosetron, Amphotericin B).

What mechanism field is on file for Buprenorphine and Ketoconazole?

Ketoconazole interferes with the enzymes that break down buprenorphine, which can change the amount of medicine that stays in your blood.

Ketoconazole carries more major-labeled pairs than Buprenorphine

SPL source-record counts only. This page's band is minor · classes on file: Buprenorphine (Partial Opioid Agonist); Ketoconazole (Azole Antifungal).

Ketoconazole has 6 major-labeled pairs vs Buprenorphine's 0. This page itself is in the minor band, not the major band.

Buprenorphine

0 major · 1 moderate · 28 minor · 29 total

Ketoconazole

6 major · 22 moderate · 85 minor · 113 total

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.