Drug interactions
Levoketoconazole + Quetiapine
Severity: Major
Levoketoconazole and Quetiapine: 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 quetiapine concentrations. This increases sedation, hypotension and QT prolongation, and levoketoconazole itself prolongs QT.
What this interaction means in plain words
Levoketoconazole and Quetiapine 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; Quetiapine belongs to Central Nervous System.
Why it happens
Strong CYP3A4 inhibition reduces quetiapine metabolism, and both drugs prolong the QT interval.
What to do
Reduce the quetiapine dose to about one sixth of the usual dose during coadministration, and restore the original dose after stopping the inhibitor. Monitor ECG, sedation and blood pressure.
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 Quetiapine
- Adagrasib + Quetiapine Major
- Amiodarone + Quetiapine Major
- Amisulpride + Quetiapine Major
- Amoxapine + Quetiapine Major
- Anagrelide + Quetiapine Major
- Apalutamide + Quetiapine 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 Quetiapine?
MediHelp rates the interaction as major. Levoketoconazole and Quetiapine 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 quetiapine concentrations. This increases sedation, hypotension and QT prolongation, and levoketoconazole itself prolongs QT.
How serious is the interaction between Levoketoconazole and Quetiapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the quetiapine dose to about one sixth of the usual dose during coadministration, and restore the original dose after stopping the inhibitor. Monitor ECG, sedation and blood pressure.
What other medicines interact with Quetiapine?
MediHelp also lists interactions of Quetiapine with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Quetiapine page.
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