Ketoconazole and Apixaban Interaction
Drug interaction information between Ketoconazole and Apixaban.
Ketoconazole and Apixaban have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Ketoconazole and Apixaban. 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 blocks the enzymes and proteins that normally clear apixaban from your body. This can cause the level of apixaban in your blood to rise too high.
FDA Label Information
( 7.2 , 12.3 ) 7.1 Combined P-gp Strong CYP3A4 Inhibitors For patients receiving apixaban 5 mg or 10 mg twice daily, the dose of apixaban should be decreased by 50% when coadministered with drugs that are combined P-gp and strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir) [see Dosage and Administration (2.5) and Clinical Pharmacology ( 12.3) ].
Ketoconazole Also Interacts With
- Alfuzosin major
- Dronedarone major
- Ranolazine major
- Saxagliptin major
- Sildenafil major
Apixaban Also Interacts With
- Clopidogrel moderate
- Aspirin moderate
- Warfarin moderate
- Carbamazepine moderate
- Rifampin moderate
Frequently Asked Questions
What SPL severity band is on file for Ketoconazole + Apixaban?
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 Apixaban's 12. In the minor band specifically: Ketoconazole has 85 (also Abiraterone, Acetaminophen/Oxycodone, Alosetron, Amphotericin B); Apixaban has 3 (also Clarithromycin, Itraconazole).
What mechanism field is on file for Ketoconazole and Apixaban?
Ketoconazole blocks the enzymes and proteins that normally clear apixaban from your body. This can cause the level of apixaban in your blood to rise too high.
Ketoconazole carries more major-labeled pairs than Apixaban
SPL source-record counts only. This page's band is minor · classes on file: Ketoconazole (Azole Antifungal); Apixaban (Direct Oral Anticoagulant (Factor Xa Inhibitor)).
Ketoconazole has 6 major-labeled pairs vs Apixaban's 0. This page itself is in the minor band, not the major band.
6 major · 22 moderate · 85 minor · 113 total
- Other minor peers for Ketoconazole
- Abiraterone
- Acetaminophen/Oxycodone
- Alosetron
- Amphotericin B
0 major · 9 moderate · 3 minor · 12 total
- Other minor peers for Apixaban
- Clarithromycin
- Itraconazole
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.