Drug interactions
Chlordiazepoxide + Levoketoconazole
Severity: Major
Chlordiazepoxide 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 is a strong CYP3A4 inhibitor that can substantially increase concentrations of CYP3A4-metabolized benzodiazepines such as chlordiazepoxide. This may cause prolonged sedation and respiratory depression.
What this interaction means in plain words
Chlordiazepoxide 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.
Chlordiazepoxide belongs to Central Nervous System; Levoketoconazole belongs to Endocrine.
Why it happens
Strong CYP3A4 inhibition reduces the oxidative metabolism of chlordiazepoxide.
What to do
Avoid the combination if possible, or reduce the chlordiazepoxide dose and monitor closely for sedation and respiratory depression. Consider a benzodiazepine cleared by glucuronidation such as lorazepam.
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 Chlordiazepoxide
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 Chlordiazepoxide with Levoketoconazole?
MediHelp rates the interaction as major. Chlordiazepoxide 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 that can substantially increase concentrations of CYP3A4-metabolized benzodiazepines such as chlordiazepoxide. This may cause prolonged sedation and respiratory depression.
How serious is the interaction between Chlordiazepoxide 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, or reduce the chlordiazepoxide dose and monitor closely for sedation and respiratory depression. Consider a benzodiazepine cleared by glucuronidation such as lorazepam.
What other medicines interact with Chlordiazepoxide?
MediHelp also lists interactions of Chlordiazepoxide with, for example, Alfentanil, Alprazolam, Amobarbital. The full list is on the Chlordiazepoxide page.
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