Drug interactions
Fluticasone-vilanterol + Levoketoconazole
Severity: Major
Fluticasone-vilanterol 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 can increase systemic exposure to fluticasone furoate and vilanterol. Increased corticosteroid and beta-agonist effects, including adrenal suppression, tachycardia and hypokalemia, may result. Levoketoconazole itself prolongs QT, which adds to arrhythmia concern.
What this interaction means in plain words
Fluticasone-vilanterol 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-vilanterol belongs to Respiratory; Levoketoconazole belongs to Endocrine.
Why it happens
Inhibition of CYP3A4-mediated metabolism, plus additive QT effects from levoketoconazole and the beta-agonist.
What to do
Avoid if possible or monitor ECG, potassium and heart rate closely. Consider an alternative inhaled regimen less dependent on CYP3A4.
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 Fluticasone-vilanterol
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-vilanterol with Levoketoconazole?
MediHelp rates the interaction as major. Fluticasone-vilanterol 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 increase systemic exposure to fluticasone furoate and vilanterol. Increased corticosteroid and beta-agonist effects, including adrenal suppression, tachycardia and hypokalemia, may result. Levoketoconazole itself prolongs QT, which adds to arrhythmia concern.
How serious is the interaction between Fluticasone-vilanterol 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 or monitor ECG, potassium and heart rate closely. Consider an alternative inhaled regimen less dependent on CYP3A4.
What other medicines interact with Fluticasone-vilanterol?
MediHelp also lists interactions of Fluticasone-vilanterol with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Fluticasone-vilanterol page.
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