Drug interactions
Levoketoconazole + Rabeprazole
Severity: Major
Levoketoconazole and Rabeprazole: 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 gastric acidity to dissolve and be absorbed. Rabeprazole reduces gastric acidity and may lower levoketoconazole exposure, reducing cortisol-lowering efficacy in Cushing syndrome.
What this interaction means in plain words
Levoketoconazole and Rabeprazole 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; Rabeprazole belongs to Gastrointestinal Tract.
Why it happens
Elevated gastric pH reduces dissolution and absorption of levoketoconazole.
What to do
Avoid proton pump inhibitors with levoketoconazole. If acid suppression is required, use a short-acting antacid taken at least 2 hours after levoketoconazole.
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 Rabeprazole
- Rabeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Rabeprazole Major
- Atazanavir + Rabeprazole Major
- Dacomitinib + Rabeprazole Major
- Dasatinib + Rabeprazole Major
- Erlotinib + Rabeprazole 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 Rabeprazole?
MediHelp rates the interaction as major. Levoketoconazole and Rabeprazole 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 gastric acidity to dissolve and be absorbed. Rabeprazole reduces gastric acidity and may lower levoketoconazole exposure, reducing cortisol-lowering efficacy in Cushing syndrome.
How serious is the interaction between Levoketoconazole and Rabeprazole?
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 required, use a short-acting antacid taken at least 2 hours after levoketoconazole.
What other medicines interact with Rabeprazole?
MediHelp also lists interactions of Rabeprazole with, for example, Rilpivirine, Acalabrutinib, Atazanavir. The full list is on the Rabeprazole page.
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