Eplerenone and Ketoconazole: Drug Interaction Guide

Quick answer: This is a major interaction — avoid combining Eplerenone and Ketoconazole unless specifically directed by your doctor.

Interaction severity: Major — avoid combination

How Eplerenone interacts with Ketoconazole

Ketoconazole strongly inhibits CYP3A4, markedly increasing eplerenone exposure and hyperkalemia risk.

What you should do

Do not co-prescribe. Choose an alternative antifungal or an alternative mineralocorticoid receptor antagonist strategy with potassium monitoring.

Key facts

Severity

Major — avoid combination

Mechanism

Ketoconazole strongly inhibits CYP3A4, markedly increasing eplerenone exposure and hyperkalemia risk.

Action

Do not co-prescribe. Choose an alternative antifungal or an alternative mineralocorticoid receptor antagonist strategy w...

Important medical disclaimer: This page provides educational information about drug interactions for general reference. It is not a substitute for professional medical advice, diagnosis, or treatment. Always discuss your specific medications with a qualified healthcare provider before starting, stopping, or changing any treatment. About our editorial team.

Frequently asked questions

Can I take Eplerenone and Ketoconazole together?

No — this combination should generally be avoided. Do not co-prescribe. Choose an alternative antifungal or an alternative mineralocorticoid receptor antagonist strategy with potassium monitoring.

What is the severity of this interaction?

The interaction between Eplerenone and Ketoconazole is classified as Major — avoid combination. Ketoconazole strongly inhibits CYP3A4, markedly increasing eplerenone exposure and hyperkalemia risk.

What should I do if I'm prescribed both?

Do not co-prescribe. Choose an alternative antifungal or an alternative mineralocorticoid receptor antagonist strategy with potassium monitoring. Always consult your prescribing clinician — do not stop or change medications without medical guidance.

Last reviewed: by iMedic Medical Editorial Team. Our editorial process.