How the interaction occurs:
Ketoconazole may slow down how quickly your liver processes your hypnotic.
What might happen:
You may notice an increase in side effects such as headaches, dry mouth, headaches, dry mouth, or drowsiness.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. If you have excessive drowsiness, contact your doctor. Your doctor may want to change the dose of your hypnotic while you are taking ketoconazole. Use caution and know how these medicines affect you before driving or operating machinery.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Lunesta (eszopiclone) US prescribing information. Sepracor Inc. January, 2008.
2.Becquemont L, Mouajjah S, Escaffre O, Beaune P, Funck-Brentano C, Jaillon P. Cytochrome P-450 3A4 and 2C8 are involved in zopiclone metabolism. Drug Metab Dispos 1999 Sep;27(9):1068-73.
3.Greenblatt DJ, von Moltke LL, Harmatz JS, Mertzanis P, Graf JA, Durol AL, Counihan M, Roth-Schechter B, Shader RI. Kinetic and dynamic interaction study of zolpidem with ketoconazole, itraconazole, and fluconazole. Clin Pharmacol Ther 1998 Dec;64(6):661-71.
4.Von Moltke LL, Greenblatt DJ, Granda BW, Duan SX, Grassi JM, Venkatakrishnan K, Harmatz JS, Shader RI. Zolpidem metabolism in vitro: responsible cytochromes, chemical inhibitors, and in vivo correlations. Br J Clin Pharmacol 1999 Jul;48(1):89-97.
5.Ambien CR (zolpidem tartrate) US prescribing information. Sanofi-Aventis U.S. LLC April, 2013.
6.Jalava KM, Olkkola KT, Neuvonen PJ. Effect of itraconazole on the pharmacokinetics and pharmacodynamics of zopiclone. Eur J Clin Pharmacol 1996;51(3-4):331-4.
7.Luurila H, Kivisto KT, Neuvonen PJ. Effect of itraconazole on the pharmacokinetics and pharmacodynamics of zolpidem. Eur J Clin Pharmacol 1998 Apr;54(2):163-6.