Drug interactions
Imipramine + Levoketoconazole
Severity: Major
Imipramine 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 prolongs the QT interval and imipramine adds to this effect, increasing the risk of torsades de pointes. Levoketoconazole also inhibits CYP3A4 and may raise imipramine exposure.
What this interaction means in plain words
Imipramine 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.
Imipramine belongs to Central Nervous System; Levoketoconazole belongs to Endocrine.
Why it happens
Additive QT prolongation, plus CYP3A4 inhibition that reduces imipramine clearance.
What to do
Avoid the combination where possible and use an antidepressant with minimal QT effect. If unavoidable, monitor ECG and electrolytes and watch for tricyclic toxicity.
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 Imipramine
- Dronedarone + Imipramine Contraindicated
- Imipramine + Isocarboxazid Contraindicated
- Imipramine + Phenelzine Contraindicated
- Imipramine + Pimozide Contraindicated
- Imipramine + Rasagiline Contraindicated
- Imipramine + Safinamide 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 Imipramine with Levoketoconazole?
MediHelp rates the interaction as major. Imipramine 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 prolongs the QT interval and imipramine adds to this effect, increasing the risk of torsades de pointes. Levoketoconazole also inhibits CYP3A4 and may raise imipramine exposure.
How serious is the interaction between Imipramine 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 and use an antidepressant with minimal QT effect. If unavoidable, monitor ECG and electrolytes and watch for tricyclic toxicity.
What other medicines interact with Imipramine?
MediHelp also lists interactions of Imipramine with, for example, Dronedarone, Isocarboxazid, Phenelzine. The full list is on the Imipramine page.
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