Drug interactions
Levoketoconazole + Paroxetine
Severity: Major
Levoketoconazole and Paroxetine: 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 prolongs the QT interval and its labeling contraindicates use with other QT-prolonging drugs that are CYP3A4 substrates. Paroxetine has a minor QT effect, and levoketoconazole may also inhibit CYP2D6, raising paroxetine concentrations.
What this interaction means in plain words
Levoketoconazole and Paroxetine 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; Paroxetine belongs to Central Nervous System.
Why it happens
Additive QT prolongation, with possible CYP2D6 inhibition by levoketoconazole increasing paroxetine exposure.
What to do
Avoid if a less QT-active antidepressant can be used. If combined, obtain a baseline and follow-up ECG, correct electrolytes and monitor for paroxetine adverse effects.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline 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 Paroxetine?
MediHelp rates the interaction as major. Levoketoconazole and Paroxetine 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 prolongs the QT interval and its labeling contraindicates use with other QT-prolonging drugs that are CYP3A4 substrates. Paroxetine has a minor QT effect, and levoketoconazole may also inhibit CYP2D6, raising paroxetine concentrations.
How serious is the interaction between Levoketoconazole and Paroxetine?
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 if a less QT-active antidepressant can be used. If combined, obtain a baseline and follow-up ECG, correct electrolytes and monitor for paroxetine adverse effects.
What other medicines interact with Paroxetine?
MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Paroxetine page.
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