Drug & supplement interaction

Ligandrol + Ketoconazole

Ketoconazole brand name: Nizoral.

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

Ligandrol has a moderate interaction with Ketoconazole. Theoretically, concomitant use might have additive hepatotoxic effects.

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

Ligandrol and Ketoconazole

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

Moderate

HEPATOTOXIC DRUGS

Why this applies to Ketoconazole

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

Theoretically, concomitant use might have additive hepatotoxic effects.
In case reports, patients were diagnosed with liver injury thought to be related to the use of products containing ligandrol.
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 concern with pairing these two: oral ketoconazole is already well known for being tough on the liver. It carries a serious warning about liver injury, which is one big reason doctors only reach for it when other antifungals won't work. Ligandrol (LGD-4033) has also been tied to liver damage in case reports. Putting two things that can stress the liver together may add up and raise your risk.

This isn't about one changing the other's blood levels. It's simply two liver stressors at once. The evidence here is mostly anecdotal, so it's a real but not proven worry. Warning signs would be yellowing skin or eyes, dark urine, belly pain, or unusual tiredness. Honestly, Ligandrol isn't an approved supplement and isn't worth the gamble. Please talk with your doctor or pharmacist before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Barbara M, Dhingra S, Mindikoglu AL. Drug-induced liver injury associated with alpha bolic (RAD-140) and alpha elite (RAD-140 and LGD-4033). ACG Case Rep J 2020;7(6):e00409. PubMed
  2. Barbara M, Dhingra S, Mindikoglu AL. Ligandrol (LGD-4033)-Induced Liver Injury. ACG Case Rep J 2020;7(6):e00370. PubMed
  3. Koller T, Vrbova P, Meciarova I, et al. Liver injury associated with the use of selective androgen receptor modulators and post-cycle therapy: Two case reports and literature review. World J Clin Cases 2021;9(16):4062-4071. PubMed
  4. Flores JE, Chitturi S, Walker S. Drug-induced liver injury by selective androgenic receptor modulators. Hepatol Commun. 2020;4(3):450-452. 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

Ligandrol Also Interacts With Other Medications

Ligandrol has 371 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.

Moderate 371 No known interaction 2,459 (incl. Ketoconazole)
Taking anything else?

Check Another of Your Medications Against Ligandrol

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

From our Q&A

Questions About Ligandrol 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 Ligandrol 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 Ligandrol 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

One more smart check

Taking Ligandrol as Part of a Dietary Supplement Product? Check It for Interactions

We hold 26 real supplement products containing Ligandrol, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ligandrol. Your product may carry other ingredients that interact with Ketoconazole too, on top of Ligandrol — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Ligandrol 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 Ligandrol
Steady interest

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

29 days ago today
Medication Ketoconazole
Steady interest

#2,243 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 Ligandrol

What is Ligandrol?

  • Muscle building
  • Athletic performance and strength
  • Body recomposition
  • Bodybuilding cycles

Ligandrol (LGD-4033) is a synthetic selective androgen receptor modulator (SARM), not a natural herb or approved dietary supplement. It is not approved for human use, is banned in sports, and has been linked to liver injury and hormonal disruption, so it should not be taken as a supplement.

Read the full Ligandrol monograph & all interactions
Medication

About Ketoconazole

What Is Ketoconazole Used For?

Brand name: Nizoral

Ketoconazole is used in different ways depending on the product. Oral tablets treat serious fungal infections that affect the whole body, but only when other antifungal treatments have failed or can't be tolerated.

Topical products (cream, foam, shampoo) treat fungal and yeast-related skin and scalp conditions. Which condition each product treats depends on the specific product, so check the label on yours.

See full Ketoconazole drug information
Keep checking

Other Drugs & Ligandrol

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

0Major
371Moderate
0Minor
2,458No known interaction
371 Moderate 2,458 No interaction
Moderate

371 interactions

Showing 60 of 371 moderate interactions — see all 371 on the Ligandrol page.

No interaction 2,458 drugs checked — show the list

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

Showing the 60 most looked-up of 2,458 medications checked with no known interaction — see the full Ligandrol list.

See the full Ligandrol 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
Ligandrol 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 Ligandrol and Ketoconazole Together: Common Questions

Can you take Ligandrol 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.
How serious is the Ligandrol 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 Ligandrol?

Our pharmacists answer your medication & supplement questions — free.

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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.