Drug interactions
Digoxin + Levoketoconazole
Severity: Moderate
Digoxin 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 may inhibit P-glycoprotein and reduce digoxin's renal and intestinal efflux, raising serum digoxin concentrations. Because digoxin has a narrow therapeutic index, this can lead to toxicity such as arrhythmias, nausea and visual disturbances.
What this interaction means in plain words
Digoxin 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.
Digoxin belongs to Cardiovascular; Levoketoconazole belongs to Endocrine.
Why it happens
Inhibition of P-glycoprotein-mediated efflux increases digoxin absorption and decreases its elimination.
What to do
Check digoxin concentrations when starting or stopping levoketoconazole and consider reducing the digoxin dose. Monitor ECG and for signs of toxicity.
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?
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Other interactions of Digoxin
- Digoxin + Lily of the valley Contraindicated
- Digoxin + Squill Contraindicated
- Adagrasib + Digoxin Major
- Amiodarone + Digoxin Major
- Amlodipine-hydrochlorothiazide-valsartan + Digoxin Major
- Amphotericin b deoxycholate + Digoxin 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 Digoxin with Levoketoconazole?
MediHelp rates the interaction as moderate. Digoxin 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 may inhibit P-glycoprotein and reduce digoxin's renal and intestinal efflux, raising serum digoxin concentrations. Because digoxin has a narrow therapeutic index, this can lead to toxicity such as arrhythmias, nausea and visual disturbances.
How serious is the interaction between Digoxin 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: Check digoxin concentrations when starting or stopping levoketoconazole and consider reducing the digoxin dose. Monitor ECG and for signs of toxicity.
What other medicines interact with Digoxin?
MediHelp also lists interactions of Digoxin with, for example, Lily of the valley, Squill, Adagrasib. The full list is on the Digoxin page.
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