Drug interactions
Fluticasone + Levoketoconazole
Severity: Major
Fluticasone 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 can raise fluticasone levels. Ketoconazole has been shown to increase systemic fluticasone exposure and reduce cortisol.
What this interaction means in plain words
Fluticasone 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.
Fluticasone belongs to Respiratory; Levoketoconazole belongs to Endocrine.
Why it happens
Strong CYP3A4 inhibition by levoketoconazole reduces fluticasone metabolism.
What to do
Avoid the combination where possible; if needed, use the lowest effective fluticasone dose and monitor for hypercortisolism and adrenal suppression.
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 Fluticasone
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 Fluticasone with Levoketoconazole?
MediHelp rates the interaction as major. Fluticasone 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 can raise fluticasone levels. Ketoconazole has been shown to increase systemic fluticasone exposure and reduce cortisol.
How serious is the interaction between Fluticasone 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 where possible; if needed, use the lowest effective fluticasone dose and monitor for hypercortisolism and adrenal suppression.
What other medicines interact with Fluticasone?
MediHelp also lists interactions of Fluticasone with, for example, Atazanavir, Clarithromycin, Cobicistat. The full list is on the Fluticasone page.
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