Drug interactions
Levoketoconazole + Netupitant-palonosetron
Severity: Moderate
Levoketoconazole and Netupitant-palonosetron: 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 a strong CYP3A4 inhibitor and can raise netupitant exposure. Levoketoconazole also prolongs the QT interval, and palonosetron can have minor QT effects, so combined use carries some additional cardiac risk.
What this interaction means in plain words
Levoketoconazole and Netupitant-palonosetron 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; Netupitant-palonosetron belongs to Gastrointestinal Tract.
Why it happens
CYP3A4 inhibition of netupitant metabolism, with possible additive QT prolongation.
What to do
No netupitant dose change is needed, but monitor ECG and electrolytes in patients with QT risk factors.
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 Netupitant-palonosetron
- Apomorphine + Netupitant-palonosetron Contraindicated
- Flibanserin + Netupitant-palonosetron Contraindicated
- Apalutamide + Netupitant-palonosetron Major
- Avapritinib + Netupitant-palonosetron Major
- Carbamazepine + Netupitant-palonosetron Major
- Cobimetinib + Netupitant-palonosetron 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 Netupitant-palonosetron?
MediHelp rates the interaction as moderate. Levoketoconazole and Netupitant-palonosetron 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 a strong CYP3A4 inhibitor and can raise netupitant exposure. Levoketoconazole also prolongs the QT interval, and palonosetron can have minor QT effects, so combined use carries some additional cardiac risk.
How serious is the interaction between Levoketoconazole and Netupitant-palonosetron?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No netupitant dose change is needed, but monitor ECG and electrolytes in patients with QT risk factors.
What other medicines interact with Netupitant-palonosetron?
MediHelp also lists interactions of Netupitant-palonosetron with, for example, Apomorphine, Flibanserin, Apalutamide. The full list is on the Netupitant-palonosetron page.
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