Drug interactions
Levoketoconazole + Ribociclib
Severity: Contraindicated
Levoketoconazole and Ribociclib: contraindicated 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 that increases ribociclib exposure, and both drugs prolong the QT interval. Ribociclib may also modestly raise levoketoconazole levels, so arrhythmia risk is substantially increased.
What this interaction means in plain words
Levoketoconazole and Ribociclib are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Levoketoconazole belongs to Endocrine; Ribociclib belongs to Oncology.
Why it happens
CYP3A4 inhibition raising ribociclib exposure combined with additive QTc prolongation.
What to do
Avoid the combination, and consider alternative therapy for either drug. If a strong inhibitor is unavoidable, reduce ribociclib to 400 mg daily with close ECG and electrolyte monitoring.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Ribociclib
- Amiodarone + Ribociclib Contraindicated
- Cisapride + Ribociclib Contraindicated
- Dofetilide + Ribociclib Contraindicated
- Dronedarone + Ribociclib Contraindicated
- Flibanserin + Ribociclib Contraindicated
- Ibutilide + Ribociclib 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 Ribociclib?
MediHelp rates the interaction as contraindicated. Levoketoconazole and Ribociclib are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Levoketoconazole is a strong CYP3A4 inhibitor that increases ribociclib exposure, and both drugs prolong the QT interval. Ribociclib may also modestly raise levoketoconazole levels, so arrhythmia risk is substantially increased.
How serious is the interaction between Levoketoconazole and Ribociclib?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination, and consider alternative therapy for either drug. If a strong inhibitor is unavoidable, reduce ribociclib to 400 mg daily with close ECG and electrolyte monitoring.
What other medicines interact with Ribociclib?
MediHelp also lists interactions of Ribociclib with, for example, Amiodarone, Cisapride, Dofetilide. The full list is on the Ribociclib page.
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