Vorapaxar and Ketoconazole Interaction
Drug interaction information between Vorapaxar and Ketoconazole.
Vorapaxar and Ketoconazole have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Vorapaxar 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 blocks the enzyme that breaks down vorapaxar, which can cause the drug to build up to high levels in your body.
FDA Label Information
Strong CYP3A Inhibitors Avoid concomitant use of ZONTIVITY with strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, posaconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, boceprevir, telaprevir, telithromycin and conivaptan) [see Warnings and Precautions (5.2) and Clinical Pharmacology (12.3) ] .
Vorapaxar Also Interacts With
- Carbamazepine moderate
- Clarithromycin moderate
- Rifampin moderate
- Posaconazole moderate
- Itraconazole moderate
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 Vorapaxar + 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 Vorapaxar's 8. In the moderate band specifically: Vorapaxar has 7 (also Carbamazepine, Clarithromycin, Rifampin, Posaconazole); Ketoconazole has 22 (also Alprazolam, Aprepitant, Budesonide/Formoterol, Dexamethasone).
What mechanism field is on file for Vorapaxar and Ketoconazole?
Ketoconazole blocks the enzyme that breaks down vorapaxar, which can cause the drug to build up to high levels in your body.
Ketoconazole carries more major-labeled pairs than Vorapaxar
SPL source-record counts only. This page's band is moderate · classes on file: Vorapaxar (PAR-1 Antagonist (Antiplatelet)); Ketoconazole (Azole Antifungal).
Ketoconazole has 6 major-labeled pairs vs Vorapaxar's 0. This page itself is in the moderate band, not the major band.
0 major · 7 moderate · 1 minor · 8 total
- Other moderate peers for Vorapaxar
- Carbamazepine
- Clarithromycin
- Rifampin
- Posaconazole
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.