Drug interactions
Levoketoconazole + Tamoxifen
Severity: Moderate
Levoketoconazole and Tamoxifen: 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 may increase tamoxifen exposure while reducing N-desmethyltamoxifen formation. Levoketoconazole also carries QT prolongation risk, and tamoxifen can add to it.
What this interaction means in plain words
Levoketoconazole and Tamoxifen 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; Tamoxifen belongs to Endocrine.
Why it happens
Levoketoconazole inhibits CYP3A4 and CYP2C9, altering tamoxifen metabolism, with additive QT effects.
What to do
Monitor ECG and electrolytes, and watch for tamoxifen adverse effects. Consider alternatives if QTc is prolonged.
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 Tamoxifen
- Amiodarone + Tamoxifen Major
- Anastrozole + Tamoxifen Major
- Bupropion + Tamoxifen Major
- Carbamazepine + Tamoxifen Major
- Cinacalcet + Tamoxifen Major
- Dacomitinib + Tamoxifen Major
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 Tamoxifen?
MediHelp rates the interaction as moderate. Levoketoconazole and Tamoxifen 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 may increase tamoxifen exposure while reducing N-desmethyltamoxifen formation. Levoketoconazole also carries QT prolongation risk, and tamoxifen can add to it.
How serious is the interaction between Levoketoconazole and Tamoxifen?
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 ECG and electrolytes, and watch for tamoxifen adverse effects. Consider alternatives if QTc is prolonged.
What other medicines interact with Tamoxifen?
MediHelp also lists interactions of Tamoxifen with, for example, Amiodarone, Anastrozole, Bupropion. The full list is on the Tamoxifen page.
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