Drug & supplement interaction

Beer + Ketoconazole

Ketoconazole brand name: Nizoral.

Major Interaction
Medically reviewed by · Updated September 2026
The bottom line Major

Beer has a major interaction with Ketoconazole. Concomitant use of alcohol with hepatotoxic drugs may increase the risk of hepatotoxicity.

Read the full interaction report
SeverityMajor
LikelihoodProbable
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Beer and Ketoconazole

Here is the interaction we found between these two, with the evidence behind it.

Major

HEPATOTOXIC DRUGS

Why this applies to Ketoconazole

Ketoconazole falls under HEPATOTOXIC DRUGS — the group Beer interacts with.

Concomitant use of alcohol with hepatotoxic drugs may increase the risk of hepatotoxicity.
Concomitant use of excessive amounts of alcohol with potentially hepatotoxic drugs can increase the risk of liver damage.
Severity Major Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing about oral ketoconazole: it's one of the harder antifungals on the liver. It can cause liver irritation on its own, which is a big reason doctors now reserve it for situations where other options won't work. Adding beer to the mix piles on, because alcohol is also processed by the liver and can damage it. Using the two together raises your odds of liver trouble.

Watch for signs like yellowing of the skin or eyes, dark urine, pale stools, belly pain on the upper right side, nausea, or feeling unusually wiped out. An occasional drink isn't the same as steady or heavy drinking, but with this medicine I'd play it safe. Please check with your pharmacist or doctor before mixing the two.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
  2. Thummel, K. E., Slattery, J. T., Ro, H., Chien, J. Y., Nelson, S. D., Lown, K. E., and Watkins, P. B. Ethanol and production of the hepatotoxic metabolite of acetaminophen in healthy adults. Clin Pharmacol Ther 2000;67(6):591-599. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Beer Also Interacts With Other Medications

Beer has 653 major, 272 moderate known drug interactions in our database — the Ketoconazole one above is one of them. If you take anything else, check it against the full list below.

Major 653 Moderate 272 No known interaction 1,905 (incl. Ketoconazole)
Taking anything else?

Check Another of Your Medications Against Beer

Covers the 2,830 medications we’ve checked against Beer. Pick one to open its full report.

From our Q&A

Questions About Beer or Ketoconazole

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Beer or Ketoconazole, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Ketoconazole

This page covers Beer only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ketoconazole page lists 182 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Siberian Cocklebur (major), St. John's Wort (major) and Wine (major).

By severity: 6 major · 135 moderate · 41 minor.

From our pharmacist’s overview on the Ketoconazole page

“Ketoconazole (Nizoral) is already hard on the liver, so treat its 182 interacting supplements with genuine care, starting with the six rated major. Most of the list runs through CYP3A4, the liver enzyme ketoconazole strongly blocks, so it can raise levels of over a hundred herbal ingredients, while grapefruit pushes ketoconazole itself…”

Reviewed by 2 · Jul 18, 2026

Open the Ketoconazole interaction page

How much people look this up

Where Beer and Ketoconazole Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Beer
Top 25%

#330 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ketoconazole
Steady interest

#1,878 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Beer

What is Beer?

Beer
  • Social and recreational drinking
  • Relaxation
  • Heart health (popular belief)
  • Bone health (popular belief)
  • Source of antioxidants and B vitamins

Beer is an alcoholic beverage that contains some minerals, B vitamins, and plant compounds from hops and grain, but it is not a health supplement. Any possible benefits come only from light-to-moderate intake, and they are easily outweighed by the well-known harms of alcohol. The safest amount of alcohol for health is none, and beer should be avoided in pregnancy and breastfeeding.

Read the full Beer monograph & all interactions
Medication

About Ketoconazole

What Is Ketoconazole Used For?

Brand name: Nizoral

Ketoconazole 2% shampoo and foam are used to treat tinea versicolor (also called pityriasis versicolor) — a fungal infection caused by Pityrosporum orbiculare (also known as Malassezia furfur), a yeast that naturally lives on the skin.

This infection creates light or dark patches, most often on the trunk, neck, arms, and upper thighs. Even after the fungus is cleared, those skin patches may take months to return to their normal color — that's normal, and depends on your skin type and sun exposure. Tinea versicolor can also come back, since the fungus lives on healthy skin even when there's no active infection.

See full Ketoconazole drug information
Keep checking

Other Drugs & Beer

Browse every other medication we’ve checked against Beer — both the ones with a known interaction and the ones without. Select any drug for the full detail.

653Major
272Moderate
0Minor
1,904No known interaction
653 Major 272 Moderate 1,904 No interaction
Major

653 interactions

Showing 60 of 653 major interactions — see all 653 on the Beer page.

Moderate

272 interactions

Showing 60 of 272 moderate interactions — see all 272 on the Beer page.

No interaction 1,904 drugs checked — show the list

We also checked Beer against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,904 medications checked with no known interaction — see the full Beer list.

See the full Beer interactions page
See every supplement checked against Ketoconazole, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Beer monograph › Uses, safety, and every drug interaction in one place Ketoconazole supplement interactions › Every supplement checked against Ketoconazole, ranked by severity Ketoconazole drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Beer and Ketoconazole Together: Common Questions

Can you take Beer with Ketoconazole?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Beer and Ketoconazole interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Ketoconazole and Beer?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.