Drug interactions
Erythromycin + Levoketoconazole
Severity: Contraindicated
Erythromycin and Levoketoconazole: contraindicated interaction.
Last updated Sources: UK SmPC
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
Both agents prolong the QT interval, and levoketoconazole also strongly inhibits CYP3A4, raising erythromycin levels. Together this substantially raises the risk of torsade de pointes.
What this interaction means in plain words
Erythromycin 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.
Erythromycin belongs to Anti Bacterial; Levoketoconazole belongs to Endocrine.
Why it happens
Additive QT prolongation combined with CYP3A4 inhibition that increases erythromycin exposure.
What to do
Avoid the combination and use a non-QT-prolonging, non-CYP3A4-inhibiting antibiotic.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Erythromycin and Levoketoconazole, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
- Erythromycin 250 mg Gastro-resistant Tablets - SmPC sections 4.3/4.5 (names the partner; "and antifungals e.g fluconazole, ketoconazole and itraconazole.") — electronic medicines compendium (UK SmPC)
Other interactions of Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin 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 Erythromycin with Levoketoconazole?
MediHelp rates the interaction as contraindicated. Erythromycin 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. Both agents prolong the QT interval, and levoketoconazole also strongly inhibits CYP3A4, raising erythromycin levels. Together this substantially raises the risk of torsade de pointes.
How serious is the interaction between Erythromycin 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: Avoid the combination and use a non-QT-prolonging, non-CYP3A4-inhibiting antibiotic.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
