Drug interactions
Cyclophosphamide + Levoketoconazole
Severity: Moderate
Cyclophosphamide 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 is a strong CYP3A4 inhibitor and may reduce the conversion of cyclophosphamide to its active 4-hydroxy metabolite, which is partly mediated by CYP3A4 and CYP2B6. This could lower activation and alter efficacy, and may change exposure to toxic metabolites such as chloroacetaldehyde.
What this interaction means in plain words
Cyclophosphamide 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.
Cyclophosphamide belongs to Oncology; Levoketoconazole belongs to Endocrine.
Why it happens
Inhibition of CYP3A4-mediated hepatic bioactivation and N-dechloroethylation of cyclophosphamide.
What to do
Consider an alternative to levoketoconazole where feasible. If coadministered, monitor for reduced antitumor effect and for neurotoxicity or other toxicity, and monitor liver function.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cyclophosphamide 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.
Other interactions of Cyclophosphamide
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 Cyclophosphamide with Levoketoconazole?
MediHelp rates the interaction as moderate. Cyclophosphamide 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 is a strong CYP3A4 inhibitor and may reduce the conversion of cyclophosphamide to its active 4-hydroxy metabolite, which is partly mediated by CYP3A4 and CYP2B6. This could lower activation and alter efficacy, and may change exposure to toxic metabolites such as chloroacetaldehyde.
How serious is the interaction between Cyclophosphamide 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: Consider an alternative to levoketoconazole where feasible. If coadministered, monitor for reduced antitumor effect and for neurotoxicity or other toxicity, and monitor liver function.
What other medicines interact with Cyclophosphamide?
MediHelp also lists interactions of Cyclophosphamide with, for example, Adenovirus types 4 and 7 live, Belatacept, Bendamustine. The full list is on the Cyclophosphamide 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.
