Cerivastatin and Ketoconazole Topical: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ketoconazole Topical
Cerivastatin
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of myopathy or rhabdomyolysis
Interaction Deep Dive
Myopathy and rhabdomyolysis have been observed in patients treated with HMG-CoA reductase inhibitors. Concomitant use of systemic azole antifungal therapy and cerivastatin may result in a higher risk of myopathy or rhabdomyolysis. Coadministration of ketoconazole and cerivastatin should be undertaken with caution and patients should be carefully monitored3.
Why it happens (mechanism)
Inhibition by ketoconazole of cerivastatin metabolism
Literature reports
1 report — tap to read
a) Sixteen patients with hypercholesterolemia received cerivastatin 0.3 mg daily and itraconazole 200 mg daily, a more potent inhibitor of cytochrome P450 3A4 (CYP3A4), concurrently for ten days. Cerivastatin mean area under the concentration-time curve (AUC) increased by 38% from 23.8 to 32.9 mcg/hr/L, mean maximum concentration (Cmax) increased 15% from 4.8 to 5.6 mcg/L, and half-life increased by 64% from 3.4 to 5.5 hours. No cases of myalgia were observed 1. Although itraconazole is an inhibitor of CYP3A4 and may increase cerivastatin bioavailability, metabolism of cerivastatin by CYP2C8 may minimize this effect 2.
Common questions
Can I take Cerivastatin and Ketoconazole Topical together?
An increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Cerivastatin and Ketoconazole Topical interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Cerivastatin or Ketoconazole Topical need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Data on fileData on file: Baycol(R), cerivastatin sodium, Bayer Corporation, West Haven, CT, 1999.
- Muck W: Rational assessment of the interaction profile of cerivastatin supports its low propensity for drug interactions. Drugs 1998; 56(suppl 1):15-23. PubMed
- Product Information: Baycol(R), cerivastatin sodium. Bayer Corporation, West Haven, CT, 1999.
Keep reading about Ketoconazole Topical
Keep reading about Cerivastatin
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