Drug interactions
Lacosamide + Levoketoconazole
Severity: Moderate
Lacosamide 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 strongly inhibits CYP3A4 and also inhibits CYP2C9, both minor lacosamide pathways. Exposure may rise meaningfully in patients with renal or hepatic impairment, who have less compensatory clearance.
What this interaction means in plain words
Lacosamide 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.
Lacosamide belongs to Central Nervous System; Levoketoconazole belongs to Endocrine.
Why it happens
Inhibition of CYP3A4 and CYP2C9 reduces lacosamide metabolic clearance.
What to do
Monitor for dizziness, ataxia and ECG PR interval, especially in renal or hepatic impairment. Consider lowering the lacosamide dose in these patients.
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 Lacosamide
- Lacosamide + Zuranolone Major
- Atazanavir + Lacosamide Moderate
- Carbamazepine + Lacosamide Moderate
- Cenobamate + Lacosamide Moderate
- Clarithromycin + Lacosamide Moderate
- Daridorexant + Lacosamide Moderate
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 Lacosamide with Levoketoconazole?
MediHelp rates the interaction as moderate. Lacosamide 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 strongly inhibits CYP3A4 and also inhibits CYP2C9, both minor lacosamide pathways. Exposure may rise meaningfully in patients with renal or hepatic impairment, who have less compensatory clearance.
How serious is the interaction between Lacosamide 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: Monitor for dizziness, ataxia and ECG PR interval, especially in renal or hepatic impairment. Consider lowering the lacosamide dose in these patients.
What other medicines interact with Lacosamide?
MediHelp also lists interactions of Lacosamide with, for example, Zuranolone, Atazanavir, Carbamazepine. The full list is on the Lacosamide page.
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