Hirudotherapy + Ketoconazole
Ketoconazole brand name: Nizoral.
We found no known interaction between Hirudotherapy 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. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.
Hirudotherapy 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 Hirudotherapy in our sources. This does not guarantee that the combination is completely free of risk — research on Hirudotherapy alongside specific medications may be limited.
Worth understanding: our licensed dataset holds no drug-interaction record for Hirudotherapy 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.
Hirudotherapy is a treatment rather than something you take. Tell whoever provides it which medicines you use, and ask your prescriber whether it is appropriate for your health and treatment. 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.
Hirudotherapy safety at a glance
Safety guidance is general; always confirm with your pharmacist or doctor for your situation.
Questions About Hirudotherapy 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 Hirudotherapy 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.
See Every Supplement That Interacts With Ketoconazole
This page covers Hirudotherapy 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
Where Hirudotherapy 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.
#1,169 of 1,452 supplements looked up here in the last 7 days
#1,833 of 2,830 medications looked up here in the last 7 days
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 Hirudotherapy reference on this page ↓
- Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Hirudotherapy 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.
About Hirudotherapy
What is Hirudotherapy?
- Reconstructive and plastic surgery (relieving blood congestion in reattached tissue)
- Osteoarthritis and joint pain
- Circulation problems
- Varicose veins
- Traditional treatment for various inflammatory conditions
Hirudotherapy is the medical use of living leeches placed on the skin to draw blood and release saliva compounds that thin blood and ease congestion. It has a real, accepted role in some surgical settings (such as saving reattached fingers or skin flaps), but evidence for most other uses is limited. It should only be done by trained professionals because of risks of infection and bleeding.
Hirudo medicinalis · Hirudinidae · Whole living medicinal leech (and its saliva) · Live medicinal leeches applied to the skin by a trained practitioner
An interaction check asks whether these two react with each other — it does not ask whether Hirudotherapy is a good idea for someone in your situation. Here is what our Hirudotherapy record says about it on its own.
Hirudotherapy: dosing
There is no standardized "dose" for hirudotherapy. The number of leeches, where they are placed, and how long treatment continues are decided by the treating clinician based on the medical situation, such as how much blood is congested in a tissue flap.This is a medical procedure, not a supplement you take at home.
From our Hirudotherapy monograph — the full record covers uses, side effects and every documented interaction.
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.
Other Drugs & Hirudotherapy
Browse every other medication we’ve checked against Hirudotherapy — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
No interaction 2,829 drugs checked — show the list
We also checked Hirudotherapy against these medications and found no known interaction in our sources. Open any page to confirm.
- Apixaban ›
- Levothyroxine ›
- Amlodipine ›
- Methylphenidate ›
- Warfarin ›
- Sertraline ›
- Testosterone ›
- Losartan Potassium ›
- Ivermectin ›
- Abemaciclib ›
- Aspirin ›
- Acetaminophen ›
- Metoprolol ›
- Rosuvastatin ›
- Rivaroxaban ›
- Escitalopram ›
- Clopidogrel ›
- Atorvastatin ›
- Tadalafil ›
- Docusate ›
- Tirzepatide ›
- Ibuprofen ›
- Methamphetamine ›
- Hydroxyurea ›
- Warfarin Sodium ›
- Valacyclovir ›
- Sumatriptan ›
- Semaglutide ›
- Prednisone ›
- Lisdexamfetamine ›
- Propranolol ›
- Metformin ›
- Amitriptyline ›
- Amoxicillin ›
- Lisinopril ›
- Isotretinoin ›
- Amlodipine Besylate ›
- Methotrexate ›
- Bendamustine ›
- Bupropion ›
- Amphetamine ›
- Doxycycline ›
- Fluoxetine ›
- Acyclovir ›
- Azithromycin ›
- Lamotrigine ›
- Pregabalin ›
- Dextroamphetamine ›
- Gabapentin ›
- Acetaminophen, Codeine ›
- Clonazepam ›
- Quetiapine ›
- Levothyroxine, Liothyronine ›
- Naproxen ›
- Omeprazole ›
- Letrozole ›
- Methylene Blue ›
- Duloxetine ›
- Buspirone ›
- Citalopram ›
Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Hirudotherapy list.
Hirudotherapy References
The 15 references that drive our Hirudotherapy 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.
- Altamura D, Calonje E, Liau Jl, Rogers M, Verdolini R. Diffuse cutaneous pseudolymphoma due to therapy with medicinal leeches. JAMA Dermatol. 2014;150(7):783-4. PubMed
- Bibbo C, Fritsche T, Stemper M, Hall M. Flap infection associated with medicinal leeches in reconstructive surgery: two new drug-resistant organisms. J Reconstr Microsurg. 2013;29(7):457-60. PubMed
- Khelifa E, Kaya G, Laffitte E. Cutaneous pseudolymphomas after leech therapy. J Dermatol. 2013;40(8):674-5. doi: PubMed
- Michalsen A, Lüdtke R, Cesur O, et al. Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial. Pain. 2008;137(2):452-9. PubMed
- Pietrzak A, Kanitakis J, Tomasiewicz K, et al. Cutaneous complications of improper leech application. Ann Agric Environ Med. 2012;19(4):790-2.
- van Alphen NA, Gonzalez A, McKenna MC, McKenna TK, Carlsen BT, Moran SL. Ciprofloxacin-resistant Aeromonas infection following leech therapy for digit replantation: report of 2 cases. J Hand Surg Am. 2014;39(3):499-502. PubMed
- Wang H, Zhang J, Chen L. The efficacy and safety of medical leech therapy for osteoarthritis of the knee: A meta-analysis of randomized controlled trials. Int J Surg. 2018;54(Pt A):53-61. PubMed
- Zengin S, Yarbil P, Kilic H, Al B. Prolonged bleeding due to a medicinal leech bite: another treatment method, primary suture. BMJ Case Rep. 2012;2012. pii: bcr0220125759. PubMed
- Sepaskhah M, Yazdanpanah N, Sari Aslani F, Akbarzadeh Jahromi M. Cutaneous pseudolymphoma as a rare adverse effect of medicinal leech therapy: a case report and review of the literature. Cureus. 2020 Apr 2;12(4):e7517. PubMed
- Temiz SA, Özer I, Ataseven A, Dursun R, Findik S. Cutaneous pseudolymphoma due to hirudotherapy. Turkiye Parazitol Derg. 2019;43(1):50-2. PubMed
- Daye M, Isik B, Kilinç F. Lichen planus due to hirudotherapy. Turkiye Parazitol Derg. 2021;45(2):149-52. PubMed
- Mentes BB, Leventoglu S, Osmanov I, Kösehan D, Erol T. Anal abscess due to leech therapy of hemorrhoids: mumbo jumbo is still in vogue. J Surg Case Rep. 2019 Jul 31;2019(7):rjz218. PubMed
- Kiliç M, Ak R. Orbital cellulitis due to leech therapy. Bull Emerg Trauma. 2019 Jul;7(3):335-6. PubMed
- Dolek UC, Ozdemir S, Babayeva K, Gol M. Leech Application-related Upper Gastrointestinal Bleeding: A Case Report. Bull Emerg Trauma 2023;11(1):47-50.
- Resch JC, Hedstrom R, Steiner ME, Said SM, Somani A. Hirudotherapy for limb ischemia in the pediatric intensive care unit: A retrospective observational cohort. Front Pediatr 2023;10:1011171. PubMed
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.
Having Hirudotherapy While Taking Ketoconazole: Common Questions
Is it safe to have Hirudotherapy while taking Ketoconazole?
Do Hirudotherapy and Ketoconazole have any of the same side effects?
Does Ketoconazole interact with any supplements?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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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.