Drug interactions
Levoketoconazole + Nortriptyline
Severity: Major
Levoketoconazole and Nortriptyline: 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
Both drugs can prolong the QT interval, and levoketoconazole labeling contraindicates use with certain QT-prolonging drugs. Levoketoconazole also inhibits CYP3A4 and may raise tricyclic exposure, increasing the arrhythmia risk.
What this interaction means in plain words
Levoketoconazole and Nortriptyline 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; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive QT prolongation plus metabolic inhibition of nortriptyline.
What to do
Avoid the combination where possible and choose a non-QT-prolonging antidepressant. If needed, monitor ECG, electrolytes and nortriptyline levels.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline 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 Nortriptyline?
MediHelp rates the interaction as major. Levoketoconazole and Nortriptyline 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. Both drugs can prolong the QT interval, and levoketoconazole labeling contraindicates use with certain QT-prolonging drugs. Levoketoconazole also inhibits CYP3A4 and may raise tricyclic exposure, increasing the arrhythmia risk.
How serious is the interaction between Levoketoconazole and Nortriptyline?
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 where possible and choose a non-QT-prolonging antidepressant. If needed, monitor ECG, electrolytes and nortriptyline levels.
What other medicines interact with Nortriptyline?
MediHelp also lists interactions of Nortriptyline with, for example, Disopyramide, Dofetilide, Dronedarone. The full list is on the Nortriptyline page.
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