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Drug interactions

Levoketoconazole + Sirolimus

Severity: Contraindicated

Levoketoconazole and Sirolimus: 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 and P-gp inhibitor and can markedly raise sirolimus exposure. This may cause serious toxicity, including myelosuppression, hyperlipidemia, infection and impaired wound healing.

What this interaction means in plain words

Levoketoconazole and Sirolimus 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; Sirolimus belongs to Miscellaneous.

Evidence level: High

Why it happens

Strong inhibition of CYP3A4 and P-glycoprotein reduces sirolimus metabolism and efflux.

What to do

Avoid the combination and use an alternative treatment. If the interaction cannot be avoided, specialist guidance and very close sirolimus level monitoring are needed.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Levoketoconazole with Sirolimus?

MediHelp rates the interaction as contraindicated. Levoketoconazole and Sirolimus 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 and P-gp inhibitor and can markedly raise sirolimus exposure. This may cause serious toxicity, including myelosuppression, hyperlipidemia, infection and impaired wound healing.

How serious is the interaction between Levoketoconazole and Sirolimus?

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 use an alternative treatment. If the interaction cannot be avoided, specialist guidance and very close sirolimus level monitoring are needed.

What other medicines interact with Sirolimus?

MediHelp also lists interactions of Sirolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Sirolimus page.

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