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Drug interactions

Levoketoconazole + Methadone

Severity: Contraindicated

Levoketoconazole and Methadone: contraindicated 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 prolongs the QT interval, and methadone shares both features of risk. The combination can increase methadone concentrations and the risk of torsades de pointes and respiratory depression.

What this interaction means in plain words

Levoketoconazole and Methadone are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Levoketoconazole belongs to Endocrine; Methadone belongs to Musculoskeletal.

Evidence level: High

Why it happens

CYP3A4 inhibition raises methadone exposure, with additive QT prolongation.

What to do

Do not use together; consider an alternative treatment for hypercortisolism or opioid therapy. Correct electrolytes and monitor ECG if the combination cannot be avoided.

What to ask your pharmacist

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Levoketoconazole with Methadone?

MediHelp rates the interaction as contraindicated. Levoketoconazole and Methadone are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Levoketoconazole strongly inhibits CYP3A4 and prolongs the QT interval, and methadone shares both features of risk. The combination can increase methadone concentrations and the risk of torsades de pointes and respiratory depression.

How serious is the interaction between Levoketoconazole and Methadone?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use together; consider an alternative treatment for hypercortisolism or opioid therapy. Correct electrolytes and monitor ECG if the combination cannot be avoided.

What other medicines interact with Methadone?

MediHelp also lists interactions of Methadone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Droperidol. The full list is on the Methadone page.

Full monographs, dosing and an interaction checker in the MediHelp app

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