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Drug interactions

Desipramine + Levoketoconazole

Severity: Major

Desipramine 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 prolongs the QT interval and desipramine has similar effects, so the combination increases the risk of torsades de pointes. Levoketoconazole may also raise desipramine levels, which further increases risk.

What this interaction means in plain words

Desipramine 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.

Desipramine belongs to Central Nervous System; Levoketoconazole belongs to Endocrine.

Evidence level: Moderate

Why it happens

Additive QT prolongation, with possible inhibition of CYP2D6/CYP3A4 metabolism raising desipramine exposure.

What to do

Avoid the combination if possible. If used, monitor the ECG and electrolytes, and consider reducing the desipramine dose.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Desipramine with Levoketoconazole?

MediHelp rates the interaction as major. Desipramine 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 prolongs the QT interval and desipramine has similar effects, so the combination increases the risk of torsades de pointes. Levoketoconazole may also raise desipramine levels, which further increases risk.

How serious is the interaction between Desipramine 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 possible. If used, monitor the ECG and electrolytes, and consider reducing the desipramine dose.

What other medicines interact with Desipramine?

MediHelp also lists interactions of Desipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Desipramine page.

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