Ketoconazole and Dexamethasone Interaction

Drug interaction information between Ketoconazole and Dexamethasone.

Ketoconazole and Dexamethasone have a documented moderate interaction in FDA labeling.

FDA drug labeling documents a moderate-severity interaction between Ketoconazole and Dexamethasone. 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

Ketoconazole

Azole Antifungal

Drug B

Dexamethasone

Corticosteroid

How They Interact

Ketoconazole slows down how your body breaks down the steroid, which can cause the medicine to build up to high levels. This increases your risk of having serious side effects from the steroid.

FDA Label Information

Drugs which inhibit CYP 3A4 (e.g., ketoconazole, macrolide antibiotics such as erythromycin) have the potential to result in increased plasma concentrations of corticosteroids. Ketoconazole: Ketoconazole has been reported to decrease the metabolism of certain corticosteroids by up to 60%, leading to increased risk of corticosteroid side effects. In addition, ketoconazole alone can inhibit adrenal corticosteroid synthesis and may cause adrenal insufficiency during corticosteroid withdrawal.

Frequently Asked Questions

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

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 Dexamethasone's 21. In the moderate band specifically: Ketoconazole has 22 (also Alprazolam, Aprepitant, Budesonide/Formoterol, Fesoterodine); Dexamethasone has 3 (also Aspirin, Nirmatrelvir/Ritonavir).

What mechanism field is on file for Ketoconazole and Dexamethasone?

Ketoconazole slows down how your body breaks down the steroid, which can cause the medicine to build up to high levels. This increases your risk of having serious side effects from the steroid.

Ketoconazole carries more major-labeled pairs than Dexamethasone

SPL source-record counts only. This page's band is moderate · classes on file: Ketoconazole (Azole Antifungal); Dexamethasone (Corticosteroid).

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

Ketoconazole

6 major · 22 moderate · 85 minor · 113 total

Dexamethasone

0 major · 3 moderate · 18 minor · 21 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.