Drug interactions
Fesoterodine + Levoketoconazole
Severity: Major
Fesoterodine 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
Levoketoconazole is a strong CYP3A4 inhibitor and increases exposure to the active metabolite of fesoterodine. This can intensify anticholinergic effects and may add to QT prolongation, which is also a concern with levoketoconazole.
What this interaction means in plain words
Fesoterodine 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.
Fesoterodine belongs to Genitourinary; Levoketoconazole belongs to Endocrine.
Why it happens
Strong CYP3A4 inhibition reduces the clearance of fesoterodine's active metabolite.
What to do
Limit fesoterodine to a maximum of 4 mg daily and monitor for anticholinergic toxicity. Check ECG and electrolytes given the QT risk of levoketoconazole.
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 Fesoterodine
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 Fesoterodine with Levoketoconazole?
MediHelp rates the interaction as major. Fesoterodine 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 increases exposure to the active metabolite of fesoterodine. This can intensify anticholinergic effects and may add to QT prolongation, which is also a concern with levoketoconazole.
How serious is the interaction between Fesoterodine 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: Limit fesoterodine to a maximum of 4 mg daily and monitor for anticholinergic toxicity. Check ECG and electrolytes given the QT risk of levoketoconazole.
What other medicines interact with Fesoterodine?
MediHelp also lists interactions of Fesoterodine with, for example, Bethanechol, Clozapine, Pramlintide. The full list is on the Fesoterodine page.
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