Ketoconazole Topical and Olaparib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ketoconazole Topical
Olaparib
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 olaparib exposure
Interaction Deep Dive
Avoid concomitant use of olaparib (a CYP3A4 substrate) with a strong CYP3A4 inhibitor and consider an alternative agent with less CYP3A4 inhibition. When olaparib and itraconazole (a strong CYP3A4 inhibitor) were coadministered (N=57), olaparib AUC increased by 170% and Cmax by 42%. If coadministration is required, reduce olaparib tablet to 100 mg twice daily1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of olaparib
Literature reports
1 report — tap to read
a) In a pharmacokinetic study (N=57) of concomitant use of olaparib and itraconazole (a strong CYP3A4 inhibitor), olaparib AUC increased 170% and Cmax increased 42% 1.
Common questions
Can I take Ketoconazole Topical and Olaparib together?
Increased olaparib exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ketoconazole Topical and Olaparib 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 Ketoconazole Topical or Olaparib 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 (1)
- Product Information: LYNPARZA(R) oral capsules, olaparib oral capsules. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2017. DailyMed
Keep reading about Ketoconazole Topical
Keep reading about Olaparib
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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.
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