Drug interactions
Budesonide-formoterol + Levoketoconazole
Severity: Major
Budesonide-formoterol 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 prolongs the QT interval and formoterol may add to this effect. Levoketoconazole is also a strong CYP3A4 inhibitor and can raise systemic budesonide exposure, with risk of corticosteroid effects.
What this interaction means in plain words
Budesonide-formoterol 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.
Budesonide-formoterol belongs to Respiratory; Levoketoconazole belongs to Endocrine.
Why it happens
Additive QTc prolongation plus strong CYP3A4 inhibition reducing budesonide clearance.
What to do
Avoid if possible; otherwise monitor ECG, potassium and magnesium, and watch for cushingoid effects or adrenal suppression. Consider a corticosteroid less dependent on CYP3A4.
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 Budesonide-formoterol
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 Budesonide-formoterol with Levoketoconazole?
MediHelp rates the interaction as major. Budesonide-formoterol 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 prolongs the QT interval and formoterol may add to this effect. Levoketoconazole is also a strong CYP3A4 inhibitor and can raise systemic budesonide exposure, with risk of corticosteroid effects.
How serious is the interaction between Budesonide-formoterol 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; otherwise monitor ECG, potassium and magnesium, and watch for cushingoid effects or adrenal suppression. Consider a corticosteroid less dependent on CYP3A4.
What other medicines interact with Budesonide-formoterol?
MediHelp also lists interactions of Budesonide-formoterol with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Budesonide-formoterol page.
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