Drug interactions
Levoketoconazole + Metronidazole
Severity: Moderate
Levoketoconazole and Metronidazole: 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 itself a potent CYP3A4 inhibitor and its own metabolism is not substantially affected by weak inhibitors. Metronidazole has no established effect on its exposure. However, both drugs can prolong the QT interval, and levoketoconazole carries a boxed warning for QT prolongation and hepatotoxicity.
What this interaction means in plain words
Levoketoconazole and Metronidazole 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 belongs to Endocrine; Metronidazole belongs to Anti Parasitic.
Why it happens
Additive QT-prolonging potential; any pharmacokinetic effect via CYP3A4 is minimal.
What to do
Check ECG and correct potassium and magnesium before and during co-therapy, and monitor liver tests; use a non-QT-prolonging antimicrobial if possible.
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 Metronidazole
- Ethanol + Metronidazole Contraindicated
- Metronidazole + Pimozide Contraindicated
- Amiodarone + Metronidazole Major
- Disulfiram + Metronidazole Major
- Ergotamine + Metronidazole Major
- Lomitapide + Metronidazole Major
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 Metronidazole?
MediHelp rates the interaction as moderate. Levoketoconazole and Metronidazole 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 itself a potent CYP3A4 inhibitor and its own metabolism is not substantially affected by weak inhibitors. Metronidazole has no established effect on its exposure. However, both drugs can prolong the QT interval, and levoketoconazole carries a boxed warning for QT prolongation and hepatotoxicity.
How serious is the interaction between Levoketoconazole and Metronidazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check ECG and correct potassium and magnesium before and during co-therapy, and monitor liver tests; use a non-QT-prolonging antimicrobial if possible.
What other medicines interact with Metronidazole?
MediHelp also lists interactions of Metronidazole with, for example, Ethanol, Pimozide, Amiodarone. The full list is on the Metronidazole page.
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