Drug interactions
Azithromycin + Levoketoconazole
Severity: Major
Azithromycin and Levoketoconazole: major interaction.
Last updated
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 carries a boxed warning for QT prolongation and azithromycin also prolongs QT, so the combination may raise the risk of torsades de pointes. Levoketoconazole may also increase azithromycin exposure through P-glycoprotein inhibition.
What this interaction means in plain words
Azithromycin 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.
Azithromycin belongs to Anti Bacterial; Levoketoconazole belongs to Endocrine.
Why it happens
Additive QT prolongation, plus possible P-glycoprotein inhibition raising azithromycin levels.
What to do
Avoid if possible and choose a non-QT-prolonging antibiotic. If unavoidable, monitor ECG and electrolytes closely.
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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Other interactions of Azithromycin
- Azithromycin + Cisapride Contraindicated
- Azithromycin + Domperidone Contraindicated
- Azithromycin + Dronedarone Contraindicated
- Azithromycin + Pimozide Contraindicated
- Azithromycin + Piperaquine Contraindicated
- Azithromycin + Thioridazine Contraindicated
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 Azithromycin with Levoketoconazole?
MediHelp rates the interaction as major. Azithromycin 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 carries a boxed warning for QT prolongation and azithromycin also prolongs QT, so the combination may raise the risk of torsades de pointes. Levoketoconazole may also increase azithromycin exposure through P-glycoprotein inhibition.
How serious is the interaction between Azithromycin 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 and choose a non-QT-prolonging antibiotic. If unavoidable, monitor ECG and electrolytes closely.
What other medicines interact with Azithromycin?
MediHelp also lists interactions of Azithromycin with, for example, Cisapride, Domperidone, Dronedarone. The full list is on the Azithromycin page.
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