Drug interactions
Levoketoconazole + Simvastatin
Severity: Contraindicated
Levoketoconazole and Simvastatin: 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, a potent CYP3A4 inhibitor, markedly increases simvastatin exposure and the risk of rhabdomyolysis. The combination is contraindicated.
What this interaction means in plain words
Levoketoconazole and Simvastatin 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; Simvastatin belongs to Cardiovascular.
Why it happens
Strong CYP3A4 inhibition, with possible OATP1B1 inhibition, reduces simvastatin clearance.
What to do
Do not co-administer; use pravastatin or rosuvastatin if a statin is needed during levoketoconazole therapy.
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 Simvastatin
- Atazanavir + Simvastatin Contraindicated
- Clarithromycin + Simvastatin Contraindicated
- Cobicistat + Simvastatin Contraindicated
- Cyclosporine + Simvastatin Contraindicated
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin 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 Simvastatin?
MediHelp rates the interaction as contraindicated. Levoketoconazole and Simvastatin 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, a potent CYP3A4 inhibitor, markedly increases simvastatin exposure and the risk of rhabdomyolysis. The combination is contraindicated.
How serious is the interaction between Levoketoconazole and Simvastatin?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer; use pravastatin or rosuvastatin if a statin is needed during levoketoconazole therapy.
What other medicines interact with Simvastatin?
MediHelp also lists interactions of Simvastatin with, for example, Atazanavir, Clarithromycin, Cobicistat. The full list is on the Simvastatin page.
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