Zolpidem and Ketoconazole Interaction
Drug interaction information between Zolpidem and Ketoconazole.
Zolpidem and Ketoconazole have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Zolpidem 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 liver enzyme that breaks down zolpidem, which causes the sleep medicine to stay in your body longer.
FDA Label Information
John's wort): Combination use may decrease effect ( 7.2 ) Ketoconazole: Combination use may increase effect ( 7.2 ) 7.1 CNS-Active Drugs CNS Depressants Coadministration of Zolpidem with other CNS depressants increases the risk of CNS depression. CYP3A4 Inhibitors Ketoconazole Ketoconazole, a potent CYP3A4 inhibitor, increased the exposure to and pharmacodynamic effects of Zolpidem.
Zolpidem Also Interacts With
- Rifampin moderate
- Imipramine moderate
- Chlorpromazine moderate
- Sertraline minor
- Fluoxetine 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 Zolpidem + 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 Zolpidem's 9. In the moderate band specifically: Zolpidem has 4 (also Rifampin, Imipramine, Chlorpromazine); Ketoconazole has 22 (also Alprazolam, Aprepitant, Budesonide/Formoterol, Dexamethasone).
What mechanism field is on file for Zolpidem and Ketoconazole?
Ketoconazole blocks the liver enzyme that breaks down zolpidem, which causes the sleep medicine to stay in your body longer.
Ketoconazole carries more major-labeled pairs than Zolpidem
SPL source-record counts only. This page's band is moderate · classes on file: Zolpidem (Non-Benzodiazepine Hypnotic (Z-Drug)); Ketoconazole (Azole Antifungal).
Ketoconazole has 6 major-labeled pairs vs Zolpidem's 0. This page itself is in the moderate band, not the major band.
0 major · 4 moderate · 5 minor · 9 total
- Other moderate peers for Zolpidem
- Rifampin
- Imipramine
- Chlorpromazine
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.