The short answer
Aluminum hydroxide can matter when it is taken as an antacid that raises stomach pH. Take the acid-neutralizing product at least one hour before or two hours after oral ketoconazole.
What this answer covers
Oral ketoconazole with aluminum hydroxide products that neutralize stomach acid. A nutrient name alone does not identify an antacid or establish its acid-neutralizing effect.
- Supplement or preparation
- Aluminum hydroxide
- Medication ingredient
- ketoconazole
Check the exact medicine and regimen
This review applies to oral ketoconazole tablets, whose use is limited because of serious systemic risks. It does not assign the same interactions to ketoconazole shampoo or skin cream. Keep the prescribed indication, other medicines and liver-monitoring plan in view.
Identify an antacid before applying the rule
The concern is reduced drug availability when stomach acidity is lowered. The ketoconazole label specifically names acid-neutralizing medicines such as aluminum hydroxide. A different mineral salt used for nutrition is not automatically equivalent, and the label on the actual product matters.
Keep the dosing order clear
Take the acid-neutralizing product at least one hour before or two hours after oral ketoconazole. Ask the pharmacist to place the antacid, meals and the complete prescription on one schedule. Do not substitute this rule for proton-pump inhibitor or H2-blocker instructions; those products can have different restrictions.
Understand what the evidence does not prove
In a small volunteer study, experimentally reduced gastric acidity lowered ketoconazole exposure. It used cimetidine and sodium bicarbonate, not every mineral supplement. Do not self-adjust the dose or add an acidic beverage to counter a suspected interaction.
Evidence and practical considerations
Timing & monitoring
The exact oral label supports an acid-neutralizing product precaution and a directional schedule, not a blanket interaction with every form of this mineral.
- Exact scope
- Oral ketoconazole with aluminum hydroxide products that neutralize stomach acid. A nutrient name alone does not identify an antacid or establish its acid-neutralizing effect. with RxNorm 6135 IN ketoconazole. Exact oral 200 mg base tablets; topical creams, shampoos and other local routes are not comparable systemic exposure.
- Medication form and route
- Oral
What remains uncertain
- Preparation-specific oral acidity precaution, not a blanket cation-chelation claim. Direction of dosing order retained; no transfer to topical/injected formulations or other acid-reducer classes.
Factors that may matter: Exact oral regimen and formulation; Booster or fixed-combination context; Mineral preparation and dosing order; Food requirements.
Read the supporting source summaries
Source 1: Current original prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Patients prescribed the specified oral regimen.
Reduced acidity impairs absorption; acid-neutralizing drugs at least one hour before or two hours after. Serious liver toxicity warning and contraindication with lovastatin/simvastatin.
How this applies: RxNorm 6135 IN ketoconazole. Exact oral 200 mg base tablets; topical creams, shampoos and other local routes are not comparable systemic exposure.
No automatic topical route transfer, fruit-extract interaction or every-mineral binding effect. Constituent bridges and liver-risk precaution distinct from exact-pair clinical event data.
Source 2: Original clinical research
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: Twelve volunteers in randomized six-treatment crossover.
Reduced gastric acidity impaired bioavailability; effects depended on the condition.
How this applies: Exact reported regimen, preparation and endpoints only; other drugs or forms remain indirect.
Abstract-only; combined acid-suppression regimen is not every calcium/magnesium supplement or isolated aluminum hydroxide. No cross-product magnitude transfer.
Source 3: Medication terminology
rxnav.nlm.nih.gov · Source check Sep 10, 2026
Population: Terminology.
ketoconazole is IN.
How this applies: Exact ingredient.
Not clinical evidence.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Research summary published | |
| Article prepared | |
| Sources checked and article drafted. |
Article revision: 3a836060c20dadfb
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.