Drug interactions
Levoketoconazole + Pioglitazone
Severity: Moderate
Levoketoconazole and Pioglitazone: 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 may modestly increase pioglitazone exposure, which is metabolized partly by CYP3A4. The main effect would be stronger glucose lowering and more fluid retention. Levoketoconazole also carries hepatotoxicity risk, which is additive with pioglitazone's hepatic concerns.
What this interaction means in plain words
Levoketoconazole and Pioglitazone 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; Pioglitazone belongs to Endocrine.
Why it happens
CYP3A4 inhibition reduces pioglitazone metabolism; CYP2C8 is the major pathway so the effect is modest.
What to do
Monitor blood glucose, edema and liver enzymes, and lower the pioglitazone dose if hypoglycemia or adverse effects develop.
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 Pioglitazone
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 Pioglitazone?
MediHelp rates the interaction as moderate. Levoketoconazole and Pioglitazone 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 may modestly increase pioglitazone exposure, which is metabolized partly by CYP3A4. The main effect would be stronger glucose lowering and more fluid retention. Levoketoconazole also carries hepatotoxicity risk, which is additive with pioglitazone's hepatic concerns.
How serious is the interaction between Levoketoconazole and Pioglitazone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose, edema and liver enzymes, and lower the pioglitazone dose if hypoglycemia or adverse effects develop.
What other medicines interact with Pioglitazone?
MediHelp also lists interactions of Pioglitazone with, for example, Insulin aspart-insulin aspart protamine, Insulin aspart, Insulin degludec-insulin aspart. The full list is on the Pioglitazone page.
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