Drug interactions
Clorazepate + Levoketoconazole
Severity: Major
Clorazepate 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 and may increase exposure to clorazepate's active metabolite. This can cause prolonged sedation, confusion and respiratory depression.
What this interaction means in plain words
Clorazepate 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.
Clorazepate belongs to Central Nervous System; Levoketoconazole belongs to Endocrine.
Why it happens
Strong inhibition of CYP3A4 reduces oxidative clearance of the benzodiazepine.
What to do
Reduce the clorazepate dose and monitor for excessive sedation, or switch to 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 Clorazepate
- Calcium / magnesium / potassium / sodium oxybates + Clorazepate Contraindicated
- Clorazepate + Sodium oxybate Contraindicated
- Alfentanil + Clorazepate Major
- Alprazolam + Clorazepate Major
- Amobarbital + Clorazepate Major
- Belladonna and opium + Clorazepate 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 Clorazepate with Levoketoconazole?
MediHelp rates the interaction as major. Clorazepate 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 may increase exposure to clorazepate's active metabolite. This can cause prolonged sedation, confusion and respiratory depression.
How serious is the interaction between Clorazepate 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: Reduce the clorazepate dose and monitor for excessive sedation, or switch to a benzodiazepine cleared by glucuronidation such as lorazepam.
What other medicines interact with Clorazepate?
MediHelp also lists interactions of Clorazepate with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Alfentanil. The full list is on the Clorazepate page.
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