Drug interactions
Levoketoconazole + Sofosbuvir-velpatasvir-voxilaprevir
Severity: Moderate
Levoketoconazole and Sofosbuvir-velpatasvir-voxilaprevir: moderate 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 and also inhibits P-gp, so it may raise velpatasvir and voxilaprevir concentrations. Because these antivirals are metabolized by CYP3A4 only partly, the expected increase is modest, but hepatotoxicity concerns with levoketoconazole make monitoring worthwhile.
What this interaction means in plain words
Levoketoconazole and Sofosbuvir-velpatasvir-voxilaprevir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Levoketoconazole belongs to Endocrine; Sofosbuvir-velpatasvir-voxilaprevir belongs to Anti Virals.
Why it happens
Levoketoconazole inhibits CYP3A4 and P-gp, reducing the metabolism and efflux of velpatasvir and voxilaprevir.
What to do
Monitor for adverse effects of the antivirals, and check liver enzymes at baseline and during co-treatment.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Sofosbuvir-velpatasvir-voxilaprevir
- Fosphenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Phenobarbital + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Phenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Primidone + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Rifampin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir 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 Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp rates the interaction as moderate. Levoketoconazole and Sofosbuvir-velpatasvir-voxilaprevir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Levoketoconazole is a strong CYP3A4 inhibitor and also inhibits P-gp, so it may raise velpatasvir and voxilaprevir concentrations. Because these antivirals are metabolized by CYP3A4 only partly, the expected increase is modest, but hepatotoxicity concerns with levoketoconazole make monitoring worthwhile.
How serious is the interaction between Levoketoconazole and Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for adverse effects of the antivirals, and check liver enzymes at baseline and during co-treatment.
What other medicines interact with Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp also lists interactions of Sofosbuvir-velpatasvir-voxilaprevir with, for example, Fosphenytoin, Phenobarbital, Phenytoin. The full list is on the Sofosbuvir-velpatasvir-voxilaprevir page.
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