Drug & supplement interaction

Shark Cartilage + 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 Shark Cartilage 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.

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Interaction report

Shark Cartilage 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 Shark Cartilage 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.

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.

Shark Cartilage safety at a glance

Shark Cartilage overall Use caution Often poorly studied, may cause digestive upset, and proven benefits are lacking.
Pregnancy Avoid Not enough safety data; avoid during pregnancy.
Breastfeeding Avoid Not enough safety data; avoid while breastfeeding.

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

Still wondering about combining Ketoconazole and Shark Cartilage? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Ketoconazole

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ketoconazole is filed under 8 classifications — including antifungals, cytochrome p450 2c19 (cyp2c19) inhibitors, cytochrome p450 2c9 (cyp2c9) inhibitors. Shark Cartilage has documented interactions with 1 drug class — the most serious being immunosuppressants (moderate) — and none of Ketoconazole’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Shark Cartilage Does Interact With Other Medications

Shark Cartilage has 121 moderate known drug interactions in our database — Ketoconazole isn’t one of them. If you take anything else, check it against the full list below.

Moderate 121 No known interaction 2,709 (incl. Ketoconazole)
Taking anything else?

Check Another of Your Medications Against Shark Cartilage

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

What to actually watch for

No Interaction Found — But Data Suggests Shark Cartilage and Ketoconazole May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • Yellowing of the skin or eyes Worth acting on Additional detail

    Shark Cartilage

    “Orally, shark cartilage can cause acute hepatitis, with symptoms including low-grade fever, jaundice, yellowing of the eyes, right upper quadrant tenderness, and elevated liver enzymes.”

    Shark Cartilage · Natural Medicines adverse-effect record, reported in hepatitis.

    1 source cited
    1. 2012. Ashar B, Vargo E. Shark cartilage-induced hepatitis [letter]. Ann Intern Med 1996;125:780-1. PubMed

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

  • Liver problems Worth acting on Additional detail

    Shark Cartilage

    “Orally, shark cartilage is generally well tolerated.

    Most Common Adverse Effects:

    Orally: Constipation, dizziness, dyspepsia, erythema, fatigue, hypotension, nausea, taste disturbance, and vomiting.

    Serious Adverse Effects (Rare):

    Orally: Altered consciousness, decreased motor strength, decreased sensation, generalized weakness, hepatitis, hyperglycemia, hypoglycemia, and peripheral edema.”

    Shark Cartilage · Natural Medicines adverse-effect record, reported in constipation.

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

  • A change in taste Additional detail

    Shark Cartilage

    Recorded for Shark Cartilage in the same Natural Medicines adverse-effect record shown under Liver problems above.

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

  • Bloating or gas Additional detail

    Shark Cartilage

    “Orally, shark cartilage can cause taste disturbances, nausea, vomiting, dyspepsia, constipation, cramping, and bloating.”

    Shark Cartilage · Natural Medicines adverse-effect record, reported in constipation.

    6 sources cited
    1. 2014. Lane IW, Comac L. Sharks don't get cancer. Garden City, NY: Avery Publishing Group; 1992.
    2. 2015. Miller DR, Anderson GT, Stark JJ, et al. Phase I/II trial of the safety and efficacy of shark cartilage in the treatment of advanced cancer. J Clin Oncol 1998;16:3649-55. PubMed
    3. 6716. Leitner SP, Rothkopf MM, Haverstick L, et al. Two phase II studies of oral dry shark cartilage powder (SCP) in patients (pts) with either metastatic breast or prostate cancer refractory to standard treatment. Proc Am Soc Clinical Oncol 1998;17:A240.
    4. 10900. Batist G, Patenaude F, Champagne P, et al. Neovastat (AE-941) in refractory renal cell carcinoma patients: report of a phase II trial with two dose levels. Ann Oncol 2002;13:1259-63..
    5. 74724. Leitner SP, Rothkopf MM, Haverstick DD, and et al. Two phase II studies of oral dry shark cartilage powder (SCP) in patients with either metastatic breast or prostate cancer refractory to standard treatment. Amer Soc Clin Oncol 1998;17:A240.
    6. 74730. Rosenbluth, RJ, Jennis, AA, Cantwell, S, and et al. Oral shark cartilage in the treatment of patients with advanced primary brain tumors. A phase II pilot study (meeting abstract). Proc Annu Meet Am Soc Clin Oncol 1999;18:A554.

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

  • Stomach upset / Constipation Additional detail

    Shark Cartilage

    Recorded for Shark Cartilage in the same Natural Medicines adverse-effect record shown under Liver problems above.

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

  • Fever Additional detail

    Shark Cartilage

    Recorded for Shark Cartilage in the same Natural Medicines adverse-effect record shown under Yellowing of the skin or eyes above.

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

  • Swelling Additional detail

    Shark Cartilage

    “Orally, shark cartilage can cause hypotension and peripheral edema.”

    Shark Cartilage · Natural Medicines adverse-effect record, reported in hypotension.

    4 sources cited
    1. 2014. Lane IW, Comac L. Sharks don't get cancer. Garden City, NY: Avery Publishing Group; 1992.
    2. 2015. Miller DR, Anderson GT, Stark JJ, et al. Phase I/II trial of the safety and efficacy of shark cartilage in the treatment of advanced cancer. J Clin Oncol 1998;16:3649-55. PubMed
    3. 6716. Leitner SP, Rothkopf MM, Haverstick L, et al. Two phase II studies of oral dry shark cartilage powder (SCP) in patients (pts) with either metastatic breast or prostate cancer refractory to standard treatment. Proc Am Soc Clinical Oncol 1998;17:A240.
    4. 10900. Batist G, Patenaude F, Champagne P, et al. Neovastat (AE-941) in refractory renal cell carcinoma patients: report of a phase II trial with two dose levels. Ann Oncol 2002;13:1259-63..

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

  • Tiredness / Dizziness Additional detail

    Shark Cartilage

    “Orally, shark cartilage can cause dizziness, altered consciousness, decreased sensation, and fatigue.”

    Shark Cartilage · Natural Medicines adverse-effect record, reported in fatigue.

    5 sources cited
    1. 2014. Lane IW, Comac L. Sharks don't get cancer. Garden City, NY: Avery Publishing Group; 1992.
    2. 2015. Miller DR, Anderson GT, Stark JJ, et al. Phase I/II trial of the safety and efficacy of shark cartilage in the treatment of advanced cancer. J Clin Oncol 1998;16:3649-55. PubMed
    3. 6716. Leitner SP, Rothkopf MM, Haverstick L, et al. Two phase II studies of oral dry shark cartilage powder (SCP) in patients (pts) with either metastatic breast or prostate cancer refractory to standard treatment. Proc Am Soc Clinical Oncol 1998;17:A240.
    4. 10900. Batist G, Patenaude F, Champagne P, et al. Neovastat (AE-941) in refractory renal cell carcinoma patients: report of a phase II trial with two dose levels. Ann Oncol 2002;13:1259-63..
    5. 74725. Milner M. A guide to the use of shark cartilage in the treatment of arthritis and other inflammatory joint diseases. Amer Chiropractor 1999;21:40-42.

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

Showing the 10 most notable of 12 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Shark Cartilage but not commonly for Ketoconazole: high blood sugar, low blood sugar and low blood pressure.

Effects for Ketoconazole come from the ADVERSE REACTIONS section of its FDA label; effects for Shark Cartilage come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

From our Q&A

Questions About Shark Cartilage 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 Shark Cartilage 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 Shark Cartilage 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 Shark Cartilage as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2 real supplement products containing Shark Cartilage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Shark Cartilage. Even though Shark Cartilage itself has no known interaction with Ketoconazole, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Shark Cartilage 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 Shark Cartilage
Steady interest

#1,209 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ketoconazole
Steady interest

#1,672 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 Shark Cartilage reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Shark Cartilage 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 Shark Cartilage

What is Shark Cartilage?

  • Cancer support (popular use)
  • Arthritis and joint pain
  • Psoriasis
  • Wound healing
  • General immune support

Shark cartilage is a supplement made from the skeletal tissue of sharks that was heavily promoted for cancer and joint conditions, but good-quality clinical trials have not shown meaningful benefit. It is generally not recommended, and there are real environmental and safety concerns, so talk with your doctor or pharmacist before considering it.

Cartilage (skeletal tissue) from sharks, often from species such as the spiny dogfish and hammerhead · Capsules, tablets, powder

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

Shark Cartilage: dosing

There is no established or standardized dose for shark cartilage, and products vary widely in their content and quality. Studies have used very different amounts and forms, so no reliable recommended dose exists.If you are considering shark cartilage despite the limited evidence, follow the directions on the product label and do not exceed them.

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

Read the full Shark Cartilage 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 & Shark Cartilage

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

0Major
121Moderate
0Minor
2,708No known interaction
121 Moderate 2,708 No interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Shark Cartilage page.

No interaction 2,708 drugs checked — show the list

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

Showing the 60 most looked-up of 2,708 medications checked with no known interaction — see the full Shark Cartilage list.

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

Shark Cartilage References

The 12 references that drive our Shark Cartilage 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. Ashar B, Vargo E. Shark cartilage-induced hepatitis [letter]. Ann Intern Med 1996;125:780-1. PubMed
  2. Lane IW, Comac L. Sharks don't get cancer. Garden City, NY: Avery Publishing Group; 1992.
  3. Miller DR, Anderson GT, Stark JJ, et al. Phase I/II trial of the safety and efficacy of shark cartilage in the treatment of advanced cancer. J Clin Oncol 1998;16:3649-55. PubMed
  4. Leitner SP, Rothkopf MM, Haverstick L, et al. Two phase II studies of oral dry shark cartilage powder (SCP) in patients (pts) with either metastatic breast or prostate cancer refractory to standard treatment. Proc Am Soc Clinical Oncol 1998;17:A240.
  5. Batist G, Patenaude F, Champagne P, et al. Neovastat (AE-941) in refractory renal cell carcinoma patients: report of a phase II trial with two dose levels. Ann Oncol 2002;13:1259-63..
  6. Merly, L., Simjee, S., and Smith, S. L. Induction of inflammatory cytokines by cartilage extracts. Int Immunopharmacol. 2007;7(3):383-391. PubMed
  7. Bargahi, A., Hassan, Z. M., Rabbani, A., Langroudi, L., Noori, S. H., and Safari, E. Effect of shark cartilage derived protein on the NK cells activity. Immunopharmacol.Immunotoxicol. 2011;33(3):403-409. PubMed
  8. Leitner SP, Rothkopf MM, Haverstick DD, and et al. Two phase II studies of oral dry shark cartilage powder (SCP) in patients with either metastatic breast or prostate cancer refractory to standard treatment. Amer Soc Clin Oncol 1998;17:A240.
  9. Milner M. A guide to the use of shark cartilage in the treatment of arthritis and other inflammatory joint diseases. Amer Chiropractor 1999;21:40-42.
  10. Rosenbluth, RJ, Jennis, AA, Cantwell, S, and et al. Oral shark cartilage in the treatment of patients with advanced primary brain tumors. A phase II pilot study (meeting abstract). Proc Annu Meet Am Soc Clin Oncol 1999;18:A554.
  11. Saad F, Klotz L, Babaian R, Lacombe L, Champagne P, and Dupont E. Phase I/II trial on AE-941 (Neovastat) in patients with metastatic refractory prostate cancer (abstract presentation). Canadian Urological Association Annual Meeting (June 24-27, 2001).
  12. Merly L, Smith SL. Pro-inflammatory properties of shark cartilage supplement. Immunopharmacol Immunotoxicol. 2015;37(2):140-7. 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.

Pharmacist Counseling Corner

Taking Shark Cartilage and Ketoconazole Together: Common Questions

Is it safe to take Shark Cartilage with Ketoconazole?
We do not list a known interaction between Shark Cartilage 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.
Do Shark Cartilage and Ketoconazole have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Shark Cartilage and Ketoconazole combination checked?
Interactions in our licensed database are recorded against drug classes. Ketoconazole is filed under 8 classifications, and Shark Cartilage has documented interactions with 1 drug class — none of Ketoconazole's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Shark Cartilage interact with any other medications?
Yes. Shark Cartilage has 121 documented drug interactions in our database — Ketoconazole is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Ketoconazole interact with any supplements?
Yes. Ketoconazole has documented interactions with 182 supplements in our database — Shark Cartilage 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

Shark Cartilage 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 12 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Ketoconazole and Shark Cartilage?

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.