The short answer
A specific grapefruit fruit-extract interaction or spacing interval with oral ketoconazole is not established by the sources checked. Have the exact extract reviewed rather than assuming that a juice interaction from another medicine applies.
What this answer covers
Oral ketoconazole with Citrus paradisi fruit extract. Grapefruit juice, fruit flesh, seed extracts and unspecified CYP probe studies are not equivalent exposures.
- Supplement or preparation
- Citrus Paradisi (Grapefruit) Fruit Extract
- 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 what the bottle contains
A grapefruit fruit extract can differ from juice, whole fruit or seed products in composition and concentration. The label’s description of ketoconazole metabolism does not establish the effect of an unspecified extract. The plant name or extract weight alone is not enough to predict drug exposure.
Keep separate interaction mechanisms apart
Oral ketoconazole absorption can fall when stomach acidity is reduced, and it also has important enzyme-mediated interactions. Evidence for one mechanism does not prove that this fruit extract produces it. Studies in which grapefruit and ketoconazole separately affect another drug do not measure this exact combination.
Ask about the complete treatment plan
Show the extract’s ingredients and amount to your pharmacist or prescriber. No validated interval was identified for this exact pair. Do not increase ketoconazole or change its food instructions to compensate for an assumed effect; its oral use requires close attention to liver risk and other medicines.
Evidence and practical considerations
Absorption & effectiveness
No exact fruit-extract clinical study supports a universal ketoconazole avoidance or spacing rule.
- Exact scope
- Oral ketoconazole with Citrus paradisi fruit extract. Grapefruit juice, fruit flesh, seed extracts and unspecified CYP probe studies are not equivalent exposures. 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
- No exact standardized fruit-extract co-use human study identified. Grapefruit or ketoconazole used as separate probes against another medicine is not direct pair evidence; no universal safe or harmful conclusion.
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: 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: 266f0d9ade025891
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.