Possible Interaction: Epinephrine and Ketoconazole

“Although antiandrogen withdrawal has moderate efficacy in patients with hormone refractory prostate carcinoma (HRPC), the effect of the simultaneous suppression of adrenal androgens with ketoconazole at the time of antiandrogen withdrawal is not known.”

“The adrenal androgens , Δ(4)-androstene-3,17-dione, dehydroepiandrosterone and dehydroepiandrosterone sulfate were significantly reduced in the patients receiving ketoconazole or AA compared to those who did not.”

“ Ketoconazole has probably been the most widely prescribed agent used to inhibit adrenal cortisol synthesis, but in July 2013 the Food and Drug Administration (FDA) and European Medicines Agency (EMEA) simultaneously issued a safety warning about the use of ketoconazole for the treatment of fungal infection because of hepatotoxicity.”

“Glucocorticoids, synthetic steroidal antiandrogens, aminoglutethimide, ketoconazole , and spironolactone also may be used to block adrenal androgens.”

“ Ketoconazole , an antifungal agent which inhibits adrenal and testicular androgenesis, administered in a dose of 400 mg 8-hourly, resulted in optimal suppression of adrenal androgens.”

“ Ketoconazole is effective for long term control of hypercortisolism of either pituitary or adrenal origin.”

“Inhibition of PKA activity with H89 or ketoconazole abolished the effects of epinephrine on CREB, suggesting that activation of the cAMP/PKA pathway by AA epoxy‐derivatives is responsible for CREB activation by α2‐ARs.”