Drug interactions
Levoketoconazole + Quinine
Severity: Major
Levoketoconazole and Quinine: 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 also prolongs the QT interval. It can substantially raise quinine levels, and both drugs add to QT risk, so torsades de pointes is a real concern.
What this interaction means in plain words
Levoketoconazole and Quinine 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; Quinine belongs to Anti Parasitic.
Why it happens
Strong CYP3A4 inhibition reduces quinine clearance, plus additive QT prolongation.
What to do
Avoid the combination where possible; if unavoidable, obtain a baseline and follow-up ECG and correct potassium and magnesium. Consider a lower quinine dose and monitor for cinchonism.
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 Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine 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 Quinine?
MediHelp rates the interaction as major. Levoketoconazole and Quinine 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 also prolongs the QT interval. It can substantially raise quinine levels, and both drugs add to QT risk, so torsades de pointes is a real concern.
How serious is the interaction between Levoketoconazole and Quinine?
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; if unavoidable, obtain a baseline and follow-up ECG and correct potassium and magnesium. Consider a lower quinine dose and monitor for cinchonism.
What other medicines interact with Quinine?
MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.
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