Drug interactions
Eplerenone + Levoketoconazole
Severity: Contraindicated
Eplerenone and Levoketoconazole: contraindicated 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 is a potent CYP3A4 inhibitor and markedly increases eplerenone exposure. This risks severe hyperkalemia and arrhythmia, and ketoconazole is a labeled contraindication with eplerenone.
What this interaction means in plain words
Eplerenone and Levoketoconazole are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Eplerenone belongs to Cardiovascular; Levoketoconazole belongs to Endocrine.
Why it happens
Strong CYP3A4 inhibition decreases eplerenone metabolism.
What to do
Do not coadminister; choose an alternative to eplerenone while levoketoconazole is used.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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References
Other interactions of Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone 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 Eplerenone with Levoketoconazole?
MediHelp rates the interaction as contraindicated. Eplerenone and Levoketoconazole are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Levoketoconazole is a potent CYP3A4 inhibitor and markedly increases eplerenone exposure. This risks severe hyperkalemia and arrhythmia, and ketoconazole is a labeled contraindication with eplerenone.
How serious is the interaction between Eplerenone and Levoketoconazole?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not coadminister; choose an alternative to eplerenone while levoketoconazole is used.
What other medicines interact with Eplerenone?
MediHelp also lists interactions of Eplerenone with, for example, Amiloride, Atazanavir, Clarithromycin. The full list is on the Eplerenone page.
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