Drug interactions
Carbamazepine + Levoketoconazole
Severity: Major
Carbamazepine 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 inhibits CYP3A4 and can raise carbamazepine concentrations, causing dizziness, ataxia, diplopia and other toxicity. Carbamazepine may in turn lower levoketoconazole exposure and reduce its effect on cortisol control.
What this interaction means in plain words
Carbamazepine 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.
Carbamazepine belongs to Central Nervous System; Levoketoconazole belongs to Endocrine.
Why it happens
CYP3A4 inhibition by levoketoconazole raises carbamazepine levels, while carbamazepine induction reduces levoketoconazole exposure.
What to do
Avoid the combination if possible. If used together, monitor carbamazepine serum levels and signs of toxicity, and watch cortisol response.
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 Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir 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 Carbamazepine with Levoketoconazole?
MediHelp rates the interaction as major. Carbamazepine 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 inhibits CYP3A4 and can raise carbamazepine concentrations, causing dizziness, ataxia, diplopia and other toxicity. Carbamazepine may in turn lower levoketoconazole exposure and reduce its effect on cortisol control.
How serious is the interaction between Carbamazepine 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 the combination if possible. If used together, monitor carbamazepine serum levels and signs of toxicity, and watch cortisol response.
What other medicines interact with Carbamazepine?
MediHelp also lists interactions of Carbamazepine with, for example, Artemether / lumefantrine, Cabotegravir, Delamanid. The full list is on the Carbamazepine page.
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