Drug & supplement interaction

Uva Ursi + Ketoconazole

Ketoconazole brand name: Nizoral.

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

Uva Ursi has a moderate interaction with Ketoconazole. Theoretically, uva ursi may decrease the metabolism of CYP3A4 substrates.

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

Uva Ursi and Ketoconazole

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Ketoconazole

Ketoconazole falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Uva Ursi interacts with.

Theoretically, uva ursi may decrease the metabolism of CYP3A4 substrates.
In vitro, uva ursi appears to inhibit CYP3A4. This effect 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 ketoconazole. Your body relies on a liver enzyme called CYP3A4 to help break this antifungal down and clear it out. In lab dish studies, uva ursi seems to slow that same enzyme. If that held true in people, ketoconazole could clear a bit more slowly and build up, which might mean a higher chance of side effects like nausea, stomach upset, headache, or, less commonly, strain on the liver.

The honest part: this is only seen in test-tube research, not in actual patients, so it's theoretical. Both ketoconazole and high-dose uva ursi can be hard on the liver on their own, so I'd loop in your pharmacist or doctor before combining them rather than guessing.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chauhan B, Yu C, Krantis A, et al. In vitro activity of uva-ursi against cytochrome P450 isoenzymes and P-glycoprotein. Can J Physiol Pharmacol. 2007;85(11):1099-107.

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

Uva Ursi Also Interacts With Other Medications

Uva Ursi has 739 moderate, 63 minor 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 739 Minor 63 No known interaction 2,028 (incl. Ketoconazole)
Taking anything else?

Check Another of Your Medications Against Uva Ursi

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

From our Q&A

Questions About Uva Ursi 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 Uva Ursi 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 Uva Ursi 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 Uva Ursi as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,423 real supplement products containing Uva Ursi, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Uva Ursi. Your product may carry other ingredients that interact with Ketoconazole too, on top of Uva Ursi — 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 Uva Ursi 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 Uva Ursi
Top 25%

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

29 days ago today
Medication Ketoconazole
Steady interest

#2,003 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 Uva Ursi

What is Uva Ursi?

Uva Ursi
  • Urinary tract infections
  • Urinary discomfort
  • Mild diuretic
  • Kidney stones
  • Skin conditions

Uva ursi is a traditional herb used mainly for urinary tract infections, and its leaves contain a compound called arbutin that may have antimicrobial effects in the urine. Evidence in people is limited, and because high doses or long-term use may be harmful to the liver and could be toxic, it should only be used short-term and with guidance from a healthcare professional. Avoid it during pregnancy and breastfeeding.

Read the full Uva Ursi 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 & Uva Ursi

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

0Major
739Moderate
63Minor
2,027No known interaction
739 Moderate 63 Minor 2,027 No interaction
Moderate

739 interactions

Showing 60 of 739 moderate interactions — see all 739 on the Uva Ursi page.

Minor

63 interactions

Showing 60 of 63 minor interactions — see all 63 on the Uva Ursi page.

No interaction 2,027 drugs checked — show the list

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

Showing the 60 most looked-up of 2,027 medications checked with no known interaction — see the full Uva Ursi list.

See the full Uva Ursi 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
Uva Ursi 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 Uva Ursi and Ketoconazole Together: Common Questions

Can you take Uva Ursi 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 Uva Ursi 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 Uva Ursi?

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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.