Ripretinib 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
Ripretinib
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 exposure of ripretinib and its active metabolite and increased risk of adverse reactions
Interaction Deep Dive
Concomitant use of ripretinib (a CYP3A substrate) with a strong CYP3A inhibitor increased the exposure of ripretinib and its active metabolite (DP-5439), which may increase the risk of adverse reactions. In clinical studies, coadministration of ripretinib with itraconazole (a strong CYP3A inhibitor and also a P-gp inhibitor) increased exposure ripretinib (Cmax by 36% and AUC(0 to infinity) by 99%) and its active metabolite. Monitor patients more frequently for adverse reactions if coadministered1.
Why it happens (mechanism)
Inhibition of CYP3A-mediated ripretinib metabolism
Literature reports
1 report — tap to read
a) In clinical studies, coadministration of ripretinib with itraconazole (a strong CYP3A inhibitor and also a P-gp inhibitor) increased ripretinib Cmax by 36% and AUC(0 to infinity) by 99% and also increased the active metabolite of ripretinib, DP-5439 AUC(0 to infinity) by 99% with no change in its Cmax 1.
Common questions
Can I take Ripretinib and Ketoconazole Topical together?
Increased exposure of ripretinib and its active metabolite and increased risk of adverse reactions Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ripretinib and Ketoconazole Topical interaction?
It is rated moderate. Can be significant — usually manageable with 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 Ripretinib 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 anything you'd monitor while I'm on both?
References (1)
- Product Information: QINLOCK(TM) oral tablets, ripretinib oral tablets. Deciphera Pharmaceuticals LLC (per FDA), Waltham, MA, 2020. DailyMed
Keep reading about Ketoconazole Topical
Keep reading about Ripretinib
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.
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