Drug interactions
Crizotinib + Levoketoconazole
Severity: Major
Crizotinib 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 is a strong CYP3A4 inhibitor and markedly increases crizotinib exposure. Both drugs can prolong the QT interval and cause hepatotoxicity, so the combination increases the risk of serious cardiac and liver adverse effects.
What this interaction means in plain words
Crizotinib 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.
Crizotinib belongs to Oncology; Levoketoconazole belongs to Endocrine.
Why it happens
Levoketoconazole strongly inhibits CYP3A4, reducing crizotinib clearance, with additive QT and hepatic effects.
What to do
Avoid the combination. If it cannot be avoided, reduce the crizotinib dose per its labeling for strong CYP3A inhibitors and monitor ECG, electrolytes and liver tests.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Crizotinib and Levoketoconazole, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Crizotinib
- Crizotinib + Flibanserin Contraindicated
- Crizotinib + Lomitapide Contraindicated
- Crizotinib + Lonafarnib Contraindicated
- Crizotinib + Pimozide Contraindicated
- Crizotinib + Saquinavir Contraindicated
- Crizotinib + Thioridazine 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 Crizotinib with Levoketoconazole?
MediHelp rates the interaction as major. Crizotinib 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 markedly increases crizotinib exposure. Both drugs can prolong the QT interval and cause hepatotoxicity, so the combination increases the risk of serious cardiac and liver adverse effects.
How serious is the interaction between Crizotinib 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 it cannot be avoided, reduce the crizotinib dose per its labeling for strong CYP3A inhibitors and monitor ECG, electrolytes and liver tests.
What other medicines interact with Crizotinib?
MediHelp also lists interactions of Crizotinib with, for example, Flibanserin, Lomitapide, Lonafarnib. The full list is on the Crizotinib page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
