Drug & supplement interaction

Cannabinol (cbn) + Ketoconazole

Ketoconazole brand name: Nizoral.

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

Ketoconazole falls into 2 drug categories that Cannabinol (cbn) can interact with; the most serious is rated moderate. Theoretically, CYP3A4 inhibitors might increase the levels and clinical effects of cannabinol.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cannabinol (cbn) and Ketoconazole

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Cannabinol (cbn) interacts with whole categories of medication. Ketoconazole falls into 2 of those categories, so it can interact with Cannabinol (cbn) in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

1 of 2

Why this applies to Ketoconazole

Ketoconazole falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS — the group Cannabinol (cbn) interacts with.

Theoretically, CYP3A4 inhibitors might increase the levels and clinical effects of cannabinol.
In vitro research shows that CYP3A4 enzymes are involved in the 8-hydroxylation of cannabinol. So far, this interaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

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

Here's the gist for this pairing. Ketoconazole is a strong blocker of a liver enzyme called CYP3A4, and that same enzyme helps your body break down CBN. So in theory, taking ketoconazole alongside CBN could slow CBN's breakdown and let more of it build up in your system. That might mean stronger CBN effects, like extra drowsiness, grogginess, or lightheadedness.

I want to be honest about the evidence, though. This idea comes only from lab (test-tube) research, and it has not been seen in real people. So it's more of a theoretical heads-up than a proven problem. Ketoconazole itself can be tough on the liver, and CBN quality varies a lot, so it's worth a quick chat with your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Watanabe K, Yamaori S, Funahashi T, Kimura T, Yamamoto I. Cytochrome P450 enzymes involved in the metabolism of tetrahydrocannabinols and cannabinol by human hepatic microsomes. Life Sci. 2007;80(15):1415-9. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) INHIBITORS

2 of 2

Ketoconazole also falls under CYTOCHROME P450 2C9 (CYP2C9) INHIBITORS.

Theoretically, CYP2C9 inhibitors might increase the levels and clinical effects of cannabinol.
In vitro research shows that CYP2C9 enzymes are involved in the 11-hydroxylation of cannabinol. So far, this interaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

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

Here's the gist for combining CBN with ketoconazole. Ketoconazole is a well-known blocker of liver enzymes, including one called CYP2C9, which your body appears to use to break down CBN. When that enzyme is slowed down, CBN may clear out of your system more slowly and build up a bit. In plain terms, the ketoconazole isn't affected here, the CBN is, so you might feel its effects (like extra drowsiness or grogginess) more strongly than expected.

I'll be straight with you though: this comes only from lab research, not from real people, so it's theoretical at this point. Still, since CBN products vary so much in quality, it's worth running this combo past your pharmacist or doctor before you try it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Watanabe K, Yamaori S, Funahashi T, Kimura T, Yamamoto I. Cytochrome P450 enzymes involved in the metabolism of tetrahydrocannabinols and cannabinol by human hepatic microsomes. Life Sci. 2007;80(15):1415-9. 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

Cannabinol (cbn) Also Interacts With Other Medications

Cannabinol (cbn) has 388 moderate known drug interactions in our database — the Ketoconazole one above is among them. If you take anything else, check it against the full list below.

Moderate 388 No known interaction 2,442 (incl. Ketoconazole)
Taking anything else?

Check Another of Your Medications Against Cannabinol (cbn)

Covers the 2,830 medications we’ve checked against Cannabinol (cbn). Pick one to open its full report.

From our Q&A

Questions About Cannabinol (cbn) 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 Cannabinol (cbn) 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 Cannabinol (cbn) 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), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (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 Cannabinol (cbn) 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 Cannabinol (cbn)
Top half

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

29 days ago today
Medication Ketoconazole
Steady interest

#1,889 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 Cannabinol (cbn)

What is Cannabinol (cbn)?

  • Sleep support
  • Relaxation
  • Pain or discomfort
  • Appetite-related concerns

Cannabinol (CBN) is a minor cannabinoid found in the cannabis plant, often marketed as a 'sleep' aid, but solid human research is very limited. Because it comes from cannabis and product quality varies widely, talk with your pharmacist or doctor before trying it, and avoid it during pregnancy and breastfeeding.

Read the full Cannabinol (cbn) 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 & Cannabinol (cbn)

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

0Major
388Moderate
0Minor
2,441No known interaction
388 Moderate 2,441 No interaction
Moderate

388 interactions

Showing 60 of 388 moderate interactions — see all 388 on the Cannabinol (cbn) page.

No interaction 2,441 drugs checked — show the list

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

Showing the 60 most looked-up of 2,441 medications checked with no known interaction — see the full Cannabinol (cbn) list.

See the full Cannabinol (cbn) 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
Cannabinol (cbn) 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 Cannabinol (cbn) and Ketoconazole Together: Common Questions

Can you take Cannabinol (cbn) with Ketoconazole?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Cannabinol (cbn) and Ketoconazole?
Ketoconazole belongs to more than one drug category, and Cannabinol (cbn) interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Cannabinol (cbn) and Ketoconazole interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Ketoconazole and Cannabinol (cbn)?

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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.