Drug interactions
Ketamine + Levoketoconazole
Severity: Moderate
Ketamine and Levoketoconazole: moderate 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 may increase ketamine exposure, prolonging sedation and dissociative or cardiovascular effects. Because ketamine is also cleared by CYP2B6, the effect is likely moderate.
What this interaction means in plain words
Ketamine and Levoketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Ketamine belongs to Central Nervous System; Levoketoconazole belongs to Endocrine.
Why it happens
Strong CYP3A4 inhibition by levoketoconazole decreases ketamine N-demethylation.
What to do
Use lower or slowly titrated ketamine doses and monitor sedation, blood pressure and heart rate. Extend observation time after dosing.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ketamine
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 Ketamine with Levoketoconazole?
MediHelp rates the interaction as moderate. Ketamine and Levoketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Levoketoconazole is a strong CYP3A4 inhibitor and may increase ketamine exposure, prolonging sedation and dissociative or cardiovascular effects. Because ketamine is also cleared by CYP2B6, the effect is likely moderate.
How serious is the interaction between Ketamine and Levoketoconazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use lower or slowly titrated ketamine doses and monitor sedation, blood pressure and heart rate. Extend observation time after dosing.
What other medicines interact with Ketamine?
MediHelp also lists interactions of Ketamine with, for example, Benzhydrocodone / acetaminophen, Brexanolone, Buprenorphine buccal. The full list is on the Ketamine page.
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