Drug interactions
Dabigatran etexilate + Levoketoconazole
Severity: Major
Dabigatran etexilate 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
Ketoconazole inhibits P-gp and increases dabigatran exposure. Levoketoconazole is the active enantiomer and is expected to behave similarly, raising bleeding risk especially in renal impairment.
What this interaction means in plain words
Dabigatran etexilate 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.
Dabigatran etexilate belongs to Cardiovascular; Levoketoconazole belongs to Endocrine.
Why it happens
P-glycoprotein inhibition by levoketoconazole reduces dabigatran efflux, increasing absorption and plasma levels.
What to do
Avoid the combination in patients with moderate or severe renal impairment, and consider dabigatran dose reduction per labeling when CrCl is 30-50 mL/min for atrial fibrillation. Monitor for bleeding and renal function.
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 Dabigatran etexilate 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 14 days on the web. No card needed.
Other interactions of Dabigatran etexilate
- Dabigatran etexilate + Defibrotide Contraindicated
- Dabigatran etexilate + Ketorolac Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
- Abciximab + Dabigatran etexilate Major
- Alteplase + Dabigatran etexilate Major
- Amiodarone + Dabigatran etexilate 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 Dabigatran etexilate with Levoketoconazole?
MediHelp rates the interaction as major. Dabigatran etexilate 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. Ketoconazole inhibits P-gp and increases dabigatran exposure. Levoketoconazole is the active enantiomer and is expected to behave similarly, raising bleeding risk especially in renal impairment.
How serious is the interaction between Dabigatran etexilate 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 in patients with moderate or severe renal impairment, and consider dabigatran dose reduction per labeling when CrCl is 30-50 mL/min for atrial fibrillation. Monitor for bleeding and renal function.
What other medicines interact with Dabigatran etexilate?
MediHelp also lists interactions of Dabigatran etexilate with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Dabigatran etexilate 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.
