Drug interactions
Levoketoconazole + Maprotiline
Severity: Major
Levoketoconazole and Maprotiline: 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 can also raise maprotiline levels, so the risk of torsades de pointes is increased. This combination is therefore a significant arrhythmia concern.
What this interaction means in plain words
Levoketoconazole and Maprotiline 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; Maprotiline belongs to Central Nervous System.
Why it happens
Additive QT prolongation, plus inhibition of CYP3A4 and CYP2D6 metabolism of maprotiline.
What to do
Avoid the combination and choose an alternative antidepressant. If unavoidable, monitor ECG and electrolytes closely.
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 Maprotiline
- Arsenic trioxide + Maprotiline Contraindicated
- Disopyramide + Maprotiline Contraindicated
- Dofetilide + Maprotiline Contraindicated
- Ibutilide + Maprotiline Contraindicated
- Isocarboxazid + Maprotiline Contraindicated
- Maprotiline + Methylene blue 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 Levoketoconazole with Maprotiline?
MediHelp rates the interaction as major. Levoketoconazole and Maprotiline 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 can also raise maprotiline levels, so the risk of torsades de pointes is increased. This combination is therefore a significant arrhythmia concern.
How serious is the interaction between Levoketoconazole and Maprotiline?
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 and choose an alternative antidepressant. If unavoidable, monitor ECG and electrolytes closely.
What other medicines interact with Maprotiline?
MediHelp also lists interactions of Maprotiline with, for example, Arsenic trioxide, Disopyramide, Dofetilide. The full list is on the Maprotiline page.
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