Drug interactions
Enzalutamide + Levoketoconazole
Severity: Major
Enzalutamide 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
Enzalutamide may markedly reduce levoketoconazole levels and weaken cortisol-lowering effect in Cushing syndrome. Levoketoconazole, a strong CYP3A4 inhibitor, may in turn raise enzalutamide exposure and its seizure and fatigue risk.
What this interaction means in plain words
Enzalutamide 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.
Enzalutamide belongs to Endocrine; Levoketoconazole belongs to Endocrine.
Why it happens
Enzalutamide induces CYP3A4 while levoketoconazole inhibits CYP3A4, each altering the other's clearance.
What to do
Avoid the combination. If it cannot be avoided, monitor cortisol control and consider reducing the enzalutamide dose while watching for adverse effects.
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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Other interactions of Enzalutamide
- Doravirine + Enzalutamide Contraindicated
- Elbasvir / grazoprevir + Enzalutamide Contraindicated
- Ensitrelvir + Enzalutamide Contraindicated
- Enzalutamide + Fostemsavir Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
- Enzalutamide + Lenacapavir 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 Enzalutamide with Levoketoconazole?
MediHelp rates the interaction as major. Enzalutamide 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. Enzalutamide may markedly reduce levoketoconazole levels and weaken cortisol-lowering effect in Cushing syndrome. Levoketoconazole, a strong CYP3A4 inhibitor, may in turn raise enzalutamide exposure and its seizure and fatigue risk.
How serious is the interaction between Enzalutamide 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 it cannot be avoided, monitor cortisol control and consider reducing the enzalutamide dose while watching for adverse effects.
What other medicines interact with Enzalutamide?
MediHelp also lists interactions of Enzalutamide with, for example, Doravirine, Elbasvir / grazoprevir, Ensitrelvir. The full list is on the Enzalutamide page.
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