Suvorexant and Ketoconazole Interaction
Drug interaction information between Suvorexant and Ketoconazole.
Suvorexant and Ketoconazole have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Suvorexant 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.
How They Interact
Ketoconazole stops your body from breaking down suvorexant, which can lead to much higher levels of the sleep medicine in your blood. This can make you feel overly tired or cause other side effects.
FDA Label Information
CYP3A Inhibitors Concomitant use of BELSOMRA with strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, posaconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, boceprevir, telaprevir, telithromycin and conivaptan) is not recommended [see Clinical Pharmacology (12.3) ].
Suvorexant Also Interacts With
- Clarithromycin moderate
- Posaconazole moderate
- Nirmatrelvir/Ritonavir moderate
- Diltiazem minor
- Ciprofloxacin minor
Ketoconazole Also Interacts With
- Alfuzosin major
- Dronedarone major
- Ranolazine major
- Saxagliptin major
- Sildenafil major
Frequently Asked Questions
What SPL severity band is on file for Suvorexant + Ketoconazole?
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 Suvorexant's 15. In the moderate band specifically: Suvorexant has 4 (also Clarithromycin, Posaconazole, Nirmatrelvir/Ritonavir); Ketoconazole has 22 (also Alprazolam, Aprepitant, Budesonide/Formoterol, Dexamethasone).
What mechanism field is on file for Suvorexant and Ketoconazole?
Ketoconazole stops your body from breaking down suvorexant, which can lead to much higher levels of the sleep medicine in your blood. This can make you feel overly tired or cause other side effects.
Ketoconazole carries more major-labeled pairs than Suvorexant
SPL source-record counts only. This page's band is moderate · classes on file: Suvorexant (Orexin Receptor Antagonist); Ketoconazole (Azole Antifungal).
Ketoconazole has 6 major-labeled pairs vs Suvorexant's 0. This page itself is in the moderate band, not the major band.
0 major · 4 moderate · 11 minor · 15 total
- Other moderate peers for Suvorexant
- Clarithromycin
- Posaconazole
- Nirmatrelvir/Ritonavir
6 major · 22 moderate · 85 minor · 113 total
- Other moderate peers for Ketoconazole
- Alprazolam
- Aprepitant
- Budesonide/Formoterol
- Dexamethasone
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.