Final answer:
When a client is on Nizoral (ketoconazole) for esophageal candidiasis, care must be taken with co-administration of other drugs, especially those metabolized by the enzyme CYP3A4 such as certain statins and blood thinners, as it could lead to increased levels and potential toxicity.
Step-by-step explanation:
When a client is taking Nizoral (ketoconazole) for esophageal candidiasis, it's important to consider drug interactions. Ketoconazole is a potent inhibitor of the enzyme CYP3A4, which metabolizes many medications, thus potentially increasing their levels. Therefore, medications that should not be given with ketoconazole include those that are also metabolized by CYP3A4 and could lead to toxicity or other adverse effects. Examples include certain cholesterol-lowering medications (like statins), blood thinners (like warfarin), and other azole antifungal agents that might lead to an increased risk of side effects or toxicity when combined. Always consult a physician or a pharmacist before combining ketoconazole with other medications.