Drug interactions
Dexamethasone + Levoketoconazole
Severity: Major
Dexamethasone 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 strongly inhibits CYP3A4 and can raise dexamethasone exposure, increasing steroid effects such as hyperglycemia, immunosuppression and adrenal suppression. Levoketoconazole itself lowers cortisol, so the combination may also complicate assessment of adrenal function.
What this interaction means in plain words
Dexamethasone 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.
Dexamethasone belongs to Endocrine; Levoketoconazole belongs to Endocrine.
Why it happens
Strong CYP3A4 inhibition reduces dexamethasone clearance.
What to do
Use the lowest effective dexamethasone dose and monitor glucose, blood pressure and signs of corticosteroid excess; consider an alternative corticosteroid less dependent on CYP3A4 when feasible.
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?
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References
Other interactions of Dexamethasone
- Bcg vaccine live + Dexamethasone Contraindicated
- Dexamethasone + Mifepristone Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexamethasone + Smallpox vaccine live Contraindicated
- Dexamethasone + Varicella virus vaccine live Contraindicated
- Dexamethasone + Yellow fever vaccine 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 Dexamethasone with Levoketoconazole?
MediHelp rates the interaction as major. Dexamethasone 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 strongly inhibits CYP3A4 and can raise dexamethasone exposure, increasing steroid effects such as hyperglycemia, immunosuppression and adrenal suppression. Levoketoconazole itself lowers cortisol, so the combination may also complicate assessment of adrenal function.
How serious is the interaction between Dexamethasone 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: Use the lowest effective dexamethasone dose and monitor glucose, blood pressure and signs of corticosteroid excess; consider an alternative corticosteroid less dependent on CYP3A4 when feasible.
What other medicines interact with Dexamethasone?
MediHelp also lists interactions of Dexamethasone with, for example, Bcg vaccine live, Mifepristone, Rilpivirine. The full list is on the Dexamethasone page.
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