Ropivacaine Ketoconazole

Ketoconazole 400 mg caused a minor reduction in the clearance of ropivacaine, which is mostly metabolized by CYP1A2 (52). 

Arlander E, Ekstrom G, Aim C, Carrillo JA, Bielenstein M, Bottiger Y, Bertilsson L, Gustafsson LL. Metabolism of ropivacaine in humans is mediated by CYP1A2 and to a minor extent by CYP3A4 an interaction study with fluvoxamine and ketoconazole as in vivo inhibitors. Chn Pharmacol Ther 1998 64(5) 484-91. 

Itraconazole may reduce the clearance of bupivacaine, and itraconazole, ketoconazole or clarithromycin may slightly decrease ropivacaine clearance, but the clinical importance of these interactions appears to be limited. 

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