Drug interactions
Levoketoconazole + Loperamide
Severity: Major
Levoketoconazole and Loperamide: 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 inhibits CYP3A4 and P-glycoprotein, and ketoconazole has been shown to markedly raise loperamide levels. Higher loperamide exposure increases risk of central opioid effects and QT prolongation, and levoketoconazole itself prolongs QT.
What this interaction means in plain words
Levoketoconazole and Loperamide 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 belongs to Endocrine; Loperamide belongs to Gastrointestinal Tract.
Why it happens
Inhibition of CYP3A4 and P-gp increases loperamide exposure, with additive QT effects.
What to do
Avoid regular or high-dose loperamide; if used, keep to the lowest dose briefly and monitor ECG and electrolytes.
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 Loperamide
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 Levoketoconazole with Loperamide?
MediHelp rates the interaction as major. Levoketoconazole and Loperamide 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 inhibits CYP3A4 and P-glycoprotein, and ketoconazole has been shown to markedly raise loperamide levels. Higher loperamide exposure increases risk of central opioid effects and QT prolongation, and levoketoconazole itself prolongs QT.
How serious is the interaction between Levoketoconazole and Loperamide?
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 regular or high-dose loperamide; if used, keep to the lowest dose briefly and monitor ECG and electrolytes.
What other medicines interact with Loperamide?
MediHelp also lists interactions of Loperamide with, for example, Amiodarone, Amisulpride, Anagrelide. The full list is on the Loperamide page.
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