Drug interactions
Levoketoconazole + Nicardipine
Severity: Major
Levoketoconazole and Nicardipine: 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 is a strong CYP3A4 inhibitor and can markedly raise nicardipine concentrations. This can cause pronounced hypotension, edema and tachycardia. Levoketoconazole also has negative effects on cardiac conduction that matter in vulnerable patients.
What this interaction means in plain words
Levoketoconazole and Nicardipine 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; Nicardipine belongs to Cardiovascular.
Why it happens
Strong inhibition of CYP3A4 by levoketoconazole reduces nicardipine first-pass and systemic clearance.
What to do
Prefer a calcium channel blocker or antihypertensive less dependent on CYP3A4, or start nicardipine at a low dose with close blood pressure monitoring. Reduce the dose as needed.
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 Nicardipine
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 Nicardipine?
MediHelp rates the interaction as major. Levoketoconazole and Nicardipine 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 is a strong CYP3A4 inhibitor and can markedly raise nicardipine concentrations. This can cause pronounced hypotension, edema and tachycardia. Levoketoconazole also has negative effects on cardiac conduction that matter in vulnerable patients.
How serious is the interaction between Levoketoconazole and Nicardipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a calcium channel blocker or antihypertensive less dependent on CYP3A4, or start nicardipine at a low dose with close blood pressure monitoring. Reduce the dose as needed.
What other medicines interact with Nicardipine?
MediHelp also lists interactions of Nicardipine with, for example, Amifostine, Amlodipine-olmesartan-hydrochlorothiazide, Betrixaban. The full list is on the Nicardipine page.
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