Drug interactions
Levoketoconazole + Tolbutamide
Severity: Moderate
Levoketoconazole and Tolbutamide: 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 may raise tolbutamide concentrations and increase the risk of hypoglycemia. Levoketoconazole itself lowers cortisol, which can alter glycemic control in patients with Cushing syndrome and diabetes.
What this interaction means in plain words
Levoketoconazole and Tolbutamide 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; Tolbutamide belongs to Endocrine.
Why it happens
Inhibition of CYP2C9-mediated tolbutamide metabolism by azole antifungal.
What to do
Monitor blood glucose frequently when starting or stopping levoketoconazole and reduce the tolbutamide dose if hypoglycemia develops. Consider an alternative antidiabetic agent if control is unstable.
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 Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
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 Tolbutamide?
MediHelp rates the interaction as moderate. Levoketoconazole and Tolbutamide 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 may raise tolbutamide concentrations and increase the risk of hypoglycemia. Levoketoconazole itself lowers cortisol, which can alter glycemic control in patients with Cushing syndrome and diabetes.
How serious is the interaction between Levoketoconazole and Tolbutamide?
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 blood glucose frequently when starting or stopping levoketoconazole and reduce the tolbutamide dose if hypoglycemia develops. Consider an alternative antidiabetic agent if control is unstable.
What other medicines interact with Tolbutamide?
MediHelp also lists interactions of Tolbutamide with, for example, Glyburide-metformin, Insulin degludec-liraglutide, Aceclofenac. The full list is on the Tolbutamide page.
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