Drug Interaction Report

Elagolix and Ketoconazole Topical: Interaction Details

Name: Elagolix and Ketoconazole Topical Interaction
Creator: Dr. Brian Staiger, PharmD, BCPS

A pharmacist-reviewed analysis of the Elagolix and Ketoconazole Topical interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Elagolix

Orilissa

Ketoconazole Topical

Extina® Foam Ketozole® Cream Kuric Nizoral AD® Shampoo Nizoral® Cream Nizoral® Shampoo Xolegel®

Medically reviewed by

Dr. Brian Staiger, PharmD, BCPS

Updated Aug 8, 2026

Editorial policy · Data sources

Interaction severity

Major

Potentially serious — often needs a change or close monitoring.

Minor

Moderate

Major

Contraindicated

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.

Of 57 documented Elagolix interactions, 46 are rated major — including this one.

Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.

Onset

unspecified

Evidence

probable

Severity

Major

What happens

Increased elagolix exposure

Interaction Deep Dive

Coadministration of elagolix (substrates of both CYP3A4 and P-gp) and ketoconazole (inhibitors of both strong CYP3A4 and P-gp) may result in increased elagolix exposure¹. Concomitant use of elagolix 200 mg twice daily and ketoconazole for more than 1 month is not recommended. Limit concomitant use of elagolix 150 mg once daily and ketoconazole to 6 months ².

Why it happens (mechanism)

Inhibition of CYP3A4-mediated metabolism of elagolix; inhibition of P-gp-mediated efflux transport of ketoconazole

Literature reports

1 report — tap to read

a) In a drug interaction study (N=11) coadministration of a single dose of elagolix 150 mg with ketoconazole 400 mg once daily resulted in a 77% increase in the Cmax of elagolix and a 120% increase in AUC ².

Common questions

Can I take Elagolix and Ketoconazole Topical together?

Increased elagolix exposure Always confirm with your pharmacist or prescriber before making any change.

How serious is the Elagolix 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 "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

Does my dose of Elagolix 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)

Product Information: Ketoconazole oral tablet, ketoconazole oral tablet. Taro Pharmaceuticals U.S.A. Inc. (per DailyMed), Hawthorne, NY, 2024. DailyMed
Product Information: ORILISSA(R) oral tablets, elagolix oral tablets. AbbVie Inc (per FDA), North Chicago, IL, 2023. DailyMed

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Elagolix

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All Elagolix interactions (57)

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Ketoconazole Topical

Keep reading about Ketoconazole Topical

All Ketoconazole Topical interactions (546) Ketoconazole Topical drug information

Also serious with: Colchicine Conivaptan Crizotinib Dabrafenib

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About our interaction database: depth, not breadth

HelloPharmacist doesn't license one of the big commercial interaction databases, so what you'll find here is not a complete list of every known drug interaction. Instead, each entry is researched, analyzed, and written up individually — documented from the published literature, reviewed by a pharmacist, and cited so you can check every source yourself.

If a combination isn't listed here, it means we haven't documented it yet — never that it's safe. For screening a full medication list, we recommend pairing this site with a comprehensive tool like the Drugs.com Interaction Checker and, most importantly, a review by your own pharmacist. For a deep, plain-English, fully sourced explanation of a specific documented interaction — that's exactly what we built this for.

This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.