Drug interactions
Codeine + Levoketoconazole
Severity: Moderate
Codeine and Levoketoconazole: moderate 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 inhibits CYP2D6 and may decrease conversion of codeine to morphine, reducing analgesia. It also inhibits CYP3A4, which may increase exposure to other opioid metabolites.
What this interaction means in plain words
Codeine and Levoketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Codeine belongs to Musculoskeletal; Levoketoconazole belongs to Endocrine.
Why it happens
Inhibition of CYP2D6 reduces formation of morphine from codeine, with additional CYP3A4 inhibition.
What to do
Monitor for reduced pain control and consider an opioid not dependent on CYP2D6 activation if analgesia is inadequate.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Codeine
- Alvimopan + Codeine Contraindicated
- Codeine + Isocarboxazid Contraindicated
- Codeine + Olanzapine / samidorphan Contraindicated
- Codeine + Phenelzine Contraindicated
- Codeine + Tranylcypromine Contraindicated
- Alfentanil + Codeine 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 Codeine with Levoketoconazole?
MediHelp rates the interaction as moderate. Codeine and Levoketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Levoketoconazole inhibits CYP2D6 and may decrease conversion of codeine to morphine, reducing analgesia. It also inhibits CYP3A4, which may increase exposure to other opioid metabolites.
How serious is the interaction between Codeine and Levoketoconazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced pain control and consider an opioid not dependent on CYP2D6 activation if analgesia is inadequate.
What other medicines interact with Codeine?
MediHelp also lists interactions of Codeine with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Codeine page.
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