Drug interactions
Axitinib + Levoketoconazole
Severity: Major
Axitinib and Levoketoconazole: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Levoketoconazole is a strong CYP3A4 inhibitor and is expected to considerably increase axitinib exposure, as seen with ketoconazole. This can heighten risk of hypertension, bleeding, and gastrointestinal toxicity.
What this interaction means in plain words
Axitinib and Levoketoconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Axitinib belongs to Oncology; Levoketoconazole belongs to Endocrine.
Why it happens
Levoketoconazole potently inhibits CYP3A4, reducing axitinib clearance.
What to do
Avoid if possible. If necessary, reduce axitinib dose by about 50% and monitor closely, returning to the prior dose after 3 to 5 half-lives of the inhibitor once stopped.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Axitinib
- Amobarbital + Axitinib Major
- Apalutamide + Axitinib Major
- Atazanavir + Axitinib Major
- Axitinib + Carbamazepine Major
- Axitinib + Clarithromycin Major
- Axitinib + Cobicistat Major
Other interactions of Levoketoconazole
- Alfuzosin + Levoketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Amiodarone + Levoketoconazole Contraindicated
- Avanafil + Levoketoconazole Contraindicated
- Cisapride + Levoketoconazole Contraindicated
- Clarithromycin + Levoketoconazole Contraindicated
Frequently asked questions
Can I take Axitinib with Levoketoconazole?
MediHelp rates the interaction as major. Axitinib and Levoketoconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Levoketoconazole is a strong CYP3A4 inhibitor and is expected to considerably increase axitinib exposure, as seen with ketoconazole. This can heighten risk of hypertension, bleeding, and gastrointestinal toxicity.
How serious is the interaction between Axitinib and Levoketoconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible. If necessary, reduce axitinib dose by about 50% and monitor closely, returning to the prior dose after 3 to 5 half-lives of the inhibitor once stopped.
What other medicines interact with Axitinib?
MediHelp also lists interactions of Axitinib with, for example, Amobarbital, Apalutamide, Atazanavir. The full list is on the Axitinib page.
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