Drug interactions
Levoketoconazole + Rimegepant
Severity: Major
Levoketoconazole and Rimegepant: 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 strongly inhibits CYP3A4 and P-glycoprotein, which can considerably raise rimegepant exposure. This increases the risk of adverse effects, and the combination is not recommended.
What this interaction means in plain words
Levoketoconazole and Rimegepant 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; Rimegepant belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4 metabolism and P-glycoprotein efflux of rimegepant.
What to do
Avoid concomitant use and select an alternative migraine therapy.
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 Rimegepant
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 Rimegepant?
MediHelp rates the interaction as major. Levoketoconazole and Rimegepant 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 strongly inhibits CYP3A4 and P-glycoprotein, which can considerably raise rimegepant exposure. This increases the risk of adverse effects, and the combination is not recommended.
How serious is the interaction between Levoketoconazole and Rimegepant?
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 concomitant use and select an alternative migraine therapy.
What other medicines interact with Rimegepant?
MediHelp also lists interactions of Rimegepant with, for example, Amobarbital, Atazanavir, Butabarbital. The full list is on the Rimegepant page.
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