Duvelisib and Ketoconazole Topical: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Duvelisib
Ketoconazole Topical
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
Increased duvelisib exposure
Interaction Deep Dive
Concomitant use of duvelisib (CYP3A4 substrate) with a strong CYP3A4 inhibitor increases duvelisib exposure, which may increase the risk of duvelisib toxicities. The increase in exposure to duvelisib is estimated to be approximately 2-fold at steady state with concomitant use. When coadministered, reduce the duvelisib dose to 15 mg twice daily1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated duvelisib metabolism
Literature reports
1 report — tap to read
a) Coadministration of ketoconazole 200 mg twice daily for 5 days (a strong CYP3A4 inhibitor), with a single oral 10 mg-dose of duvelisib increased duvelisib Cmax by 1.7-fold and AUC by 4-fold in healthy adults. Based on physiologically-based pharmacokinetic modeling and simulation, the increase in exposure to duvelisib is estimated to be approximately 2-fold at steady state when concomitantly used with strong CYP3A4 inhibitors 2.
Common questions
Can I take Duvelisib and Ketoconazole Topical together?
Increased duvelisib exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Duvelisib 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 "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Duvelisib 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 (2)
Keep reading about Duvelisib
Keep reading about Ketoconazole Topical
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist