Methylprednisolone and Ketoconazole Interaction
Drug interaction information between Methylprednisolone and Ketoconazole.
Methylprednisolone and Ketoconazole have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Methylprednisolone and Ketoconazole. 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 normally break down the steroid in your body. This causes the steroid levels to rise, which increases the risk of side effects.
What To Do
Your doctor may need to lower your steroid dose while you are taking ketoconazole. Monitor yourself closely for any new or worsening steroid side effects.
FDA Label Information
Hepatic Enzyme Inhibitors (e.g., ketoconazole, macrolide antibiotics such as erythromycin and troleandomycin): Drugs which inhibit cytochrome P450 3A4 have the potential to result in increased plasma concentrations of corticosteroids. Ketoconazole : Ketoconazole has been reported to significantly decrease the metabolism of certain corticosteroids by up to 60%, leading to an increased risk of corticosteroid side effects.
Methylprednisolone Also Interacts With
- Theophylline major
- Aspirin moderate
- Aprepitant moderate
- Clarithromycin moderate
- Darunavir moderate
Ketoconazole Also Interacts With
- Alfuzosin major
- Dronedarone major
- Ranolazine major
- Saxagliptin major
- Sildenafil major
Frequently Asked Questions
Can I take Methylprednisolone and Ketoconazole together?
This is a moderate interaction. Your doctor may need to lower your steroid dose while you are taking ketoconazole. Monitor yourself closely for any new or worsening steroid side effects.
How serious is the interaction between Methylprednisolone and Ketoconazole?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Methylprednisolone and Ketoconazole interact?
Ketoconazole blocks the enzymes that normally break down the steroid in your body. This causes the steroid levels to rise, which increases the risk of side effects.
Understanding the Methylprednisolone and Ketoconazole Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Methylprednisolone belongs to the Corticosteroid class and Ketoconazole belongs to the Azole Antifungal class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Ketoconazole blocks the enzymes that normally break down the steroid in your body. 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. Methylprednisolone has 29 total documented interactions on file in this dataset, and Ketoconazole has 113. 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: Your doctor may need to lower your steroid dose while you are taking ketoconazole. 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 Methylprednisolone or Ketoconazole 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.