Ketoconazole and Saxagliptin Interaction
Drug interaction information between Ketoconazole and Saxagliptin.
Ketoconazole and Saxagliptin have a documented major interaction in FDA labeling.
FDA drug labeling documents a major-severity interaction between Ketoconazole and Saxagliptin. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Ketoconazole blocks the enzymes that clear saxagliptin from your body, which significantly increases the amount of drug in your blood.
What To Do
Do not take these two medications at the same time.
FDA Label Information
7 DRUG INTERACTIONS Table 3: Clinically Relevant Interactions with QTERN Strong Inhibitors of CYP3A4/5 Enzymes Clinical Impact Ketoconazole significantly increased saxagliptin exposure. • Strong CYP3A4/5 Inhibitors (e.g., Ketoconazole): Do not coadminister QTERN with strong cytochrome P450 3A4/5 inhibitors.
Ketoconazole Also Interacts With
- Alfuzosin major
- Dronedarone major
- Ranolazine major
- Sildenafil major
- Theophylline major
Saxagliptin Also Interacts With
- Lithium minor
- Clarithromycin minor
- Itraconazole minor
- Nirmatrelvir/Ritonavir minor
Frequently Asked Questions
Can I take Ketoconazole and Saxagliptin together?
This is a major interaction. Do not take these two medications at the same time.
How serious is the interaction between Ketoconazole and Saxagliptin?
This interaction is classified as "major" severity by the FDA. Major interactions may be life-threatening or cause serious side effects.
Why do Ketoconazole and Saxagliptin interact?
Ketoconazole blocks the enzymes that clear saxagliptin from your body, which significantly increases the amount of drug in your blood.
Understanding the Ketoconazole and Saxagliptin Interaction
FDA-approved prescribing information for these two drugs flags their combination as a major-severity interaction. Ketoconazole belongs to the Azole Antifungal class and Saxagliptin belongs to the DPP-4 Inhibitor class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Ketoconazole blocks the enzymes that clear saxagliptin from your body, which significantly increases the amount of drug in your blood. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Ketoconazole has 113 total documented interactions on file in this dataset, and Saxagliptin has 5. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Do not take these two medications at the same time. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Ketoconazole or Saxagliptin based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.