Drug & supplement interaction

Diatomaceous Earth + Ketoconazole

Ketoconazole brand name: Nizoral.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Diatomaceous Earth and Ketoconazole in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

Diatomaceous Earth and Ketoconazole

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Ketoconazole and Diatomaceous Earth in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Diatomaceous Earth at all — not against Ketoconazole, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Diatomaceous Earth safety at a glance

Diatomaceous Earth overall Use caution Only food-grade products should be ingested, and human safety data is limited.
Pregnancy Avoid Safety has not been studied in pregnancy, so it is best avoided.
Breastfeeding Avoid There is no reliable safety data during breastfeeding, so avoid use.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Ketoconazole and Diatomaceous Earth? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Ketoconazole’s Own FDA Label Lists

This is not an interaction — none of it involves Diatomaceous Earth. These are the most notable effects listed in the ADVERSE REACTIONS section of Ketoconazole’s own FDA label, for the medication by itself. Knowing the drug’s own list makes it easier to work out the likely cause if something new turns up while you take both. 7 of them are worth acting on rather than waiting out — marked below.

  • Yellowing of the skin or eyes Worth acting on
  • A severe skin reaction Worth acting on
  • A low platelet count Worth acting on
  • A severe allergic reaction Worth acting on
  • Hives Worth acting on
  • Liver problems Worth acting on
  • Bleeding or bruising Worth acting on
  • Increased appetite
  • Changes to your period
  • Breast tenderness

Showing the 10 most notable of 38 label-listed effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

From the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed › Diatomaceous Earth’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no Diatomaceous Earth side to compare — that is a limit of the record, not a statement that Diatomaceous Earth has no side effects.

From our Q&A

Questions About Diatomaceous Earth 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 Diatomaceous Earth 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 Diatomaceous Earth 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 Diatomaceous Earth 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 Diatomaceous Earth
Steady interest

#1,393 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ketoconazole
Steady interest

#1,833 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Diatomaceous Earth reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Diatomaceous Earth and Ketoconazole records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Diatomaceous Earth

What is Diatomaceous Earth?

  • Digestive cleansing or 'detox'
  • Intestinal parasite support
  • Skin, hair, and nail health (silica)
  • Cholesterol support
  • Toxin or heavy metal binding

Diatomaceous earth is a fine powder made from the fossilized shells of tiny algae called diatoms. Only food-grade diatomaceous earth should ever be swallowed, and human evidence for its health claims (detox, parasites, cholesterol) is very limited. Never inhale the dust, and talk to a pharmacist or doctor before taking it.

Fossilized remains of diatoms (a type of algae) · Food-grade powder, capsules, mixed into water or smoothies

An interaction check asks whether these two react with each other — it does not ask whether Diatomaceous Earth is a good idea for someone in your situation. Here is what our Diatomaceous Earth record says about it on its own.

Diatomaceous Earth: dosing

There is no official, standardized dose of diatomaceous earth, and it is not approved as a medicine. Amounts vary widely between products and brands.If you choose to use it, follow the directions on a clearly labeled food-grade product, start low, and drink plenty of water.

From our Diatomaceous Earth monograph — the full record covers uses, side effects and every documented interaction.

Read the full Diatomaceous Earth 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.

Most-Reported Side Effects for Ketoconazole

From FAERS, the FDA’s public side-effect reporting system (0 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Pruritus 984 reports
Fatigue 975 reports
Nausea 873 reports
Rash 858 reports
Diarrhea 814 reports
See full Ketoconazole drug information
Keep checking

Other Drugs & Diatomaceous Earth

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

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

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

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Diatomaceous Earth list.

See the full Diatomaceous Earth interactions page
See every supplement checked against Ketoconazole, ranked by severity
Evidence & sources

Diatomaceous Earth References

The 6 references that drive our Diatomaceous Earth monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Rushton L. Chronic obstructive pulmonary disease and occupational exposure to silica. Rev Environ Health 2007;22(4):255-72. PubMed
  2. Gallagher LG, Park RM, Checkoway H. Extended follow-up of lung cancer and non-malignant respiratory disease mortality among California diatomaceous earth workers. Occup Environ Med. 2015;72(5):360-5. PubMed
  3. Moisan S, Rucay P, Ghali A, Penneau-Fontbonne D, Lavigne C. Silica-associated limited systemic sclerosis after occupational exposure to calcined diatomaceous earth. Joint Bone Spine. 2010;77(5):472-3. PubMed
  4. Park R, Rice F, Stayner L, Smith R, Gilbert S, Checkoway H. Exposure to crystalline silica, silicosis, and lung disease other than cancer in diatomaceous earth industry workers: a quantitative risk assessment. Occup Environ Med. 2002;59(1):36-43. PubMed
  5. Nattrass C, Horwell CJ, Damby DE, Kermanizadeh A, Brown DM, Stone V. The global variability of diatomaceous earth toxicity: a physicochemical and in vitro investigation. J Occup Med Toxicol. 2015 10;10:23. PubMed
  6. Wachter H, Lechleitner M, Artner-Dworzak E, Hausen A, Jarosch E, Widner B, Patsch J, Pfeiffer K, Fuchs D. Diatomaceous earth lowers blood cholesterol concentrations. Eur J Med Res. 1998 8;3(4):211-5.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Diatomaceous Earth and Ketoconazole Together: Common Questions

Is it safe to take Diatomaceous Earth with Ketoconazole?
We do not list a known interaction between Diatomaceous Earth and Ketoconazole. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Does Ketoconazole interact with any supplements?
Yes. Ketoconazole has documented interactions with 182 supplements in our database — Diatomaceous Earth is not one of them. The Ketoconazole interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Diatomaceous Earth monograph Uses, safety profile, and every drug interaction in one place Ketoconazole drug information The full plain-English guide to this medication Ketoconazole supplement interactions Every supplement checked against Ketoconazole, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 6 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Ketoconazole and Diatomaceous Earth?

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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.