Drug interactions
Levoketoconazole + Pantoprazole
Severity: Major
Levoketoconazole and Pantoprazole: 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 needs an acidic stomach to dissolve and be absorbed. Pantoprazole raises gastric pH, which can lower levoketoconazole exposure and reduce its effect on cortisol control in Cushing's syndrome.
What this interaction means in plain words
Levoketoconazole and Pantoprazole 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; Pantoprazole belongs to Gastrointestinal Tract.
Why it happens
Pantoprazole-induced increase in gastric pH reduces dissolution and oral absorption of levoketoconazole.
What to do
Avoid proton pump inhibitors with levoketoconazole; if acid suppression is needed, use a short-acting antacid separated from levoketoconazole by at least 2 hours. Monitor cortisol control.
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 Pantoprazole
- Pantoprazole + Rilpivirine Contraindicated
- Acalabrutinib + Pantoprazole Major
- Atazanavir + Pantoprazole Major
- Dacomitinib + Pantoprazole Major
- Dasatinib + Pantoprazole Major
- Erlotinib + Pantoprazole 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 Pantoprazole?
MediHelp rates the interaction as major. Levoketoconazole and Pantoprazole 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 needs an acidic stomach to dissolve and be absorbed. Pantoprazole raises gastric pH, which can lower levoketoconazole exposure and reduce its effect on cortisol control in Cushing's syndrome.
How serious is the interaction between Levoketoconazole and Pantoprazole?
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 proton pump inhibitors with levoketoconazole; if acid suppression is needed, use a short-acting antacid separated from levoketoconazole by at least 2 hours. Monitor cortisol control.
What other medicines interact with Pantoprazole?
MediHelp also lists interactions of Pantoprazole with, for example, Rilpivirine, Acalabrutinib, Atazanavir. The full list is on the Pantoprazole page.
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