Drug interactions
Erlotinib + Levoketoconazole
Severity: Major
Erlotinib 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 is a strong CYP3A4 inhibitor and also inhibits P-glycoprotein. Erlotinib exposure is expected to rise, increasing rash, diarrhea and potentially serious lung toxicity.
What this interaction means in plain words
Erlotinib 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.
Erlotinib belongs to Oncology; Levoketoconazole belongs to Endocrine.
Why it happens
Inhibition of CYP3A4 metabolism and P-glycoprotein efflux of erlotinib.
What to do
Avoid if possible. If used together, monitor for erlotinib toxicity and reduce the dose in 50 mg decrements for severe reactions.
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 Erlotinib
- Amobarbital + Erlotinib Major
- Apalutamide + Erlotinib Major
- Carbamazepine + Erlotinib Major
- Cobicistat + Erlotinib Major
- Darunavir + Erlotinib Major
- Dexlansoprazole + Erlotinib 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 Erlotinib with Levoketoconazole?
MediHelp rates the interaction as major. Erlotinib 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 is a strong CYP3A4 inhibitor and also inhibits P-glycoprotein. Erlotinib exposure is expected to rise, increasing rash, diarrhea and potentially serious lung toxicity.
How serious is the interaction between Erlotinib 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 if possible. If used together, monitor for erlotinib toxicity and reduce the dose in 50 mg decrements for severe reactions.
What other medicines interact with Erlotinib?
MediHelp also lists interactions of Erlotinib with, for example, Amobarbital, Apalutamide, Carbamazepine. The full list is on the Erlotinib page.
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