Drug interactions
Levoketoconazole + Tolterodine
Severity: Major
Levoketoconazole and Tolterodine: major 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 that raises tolterodine exposure. Both drugs prolong the QT interval, so the risk of arrhythmia and anticholinergic toxicity increases.
What this interaction means in plain words
Levoketoconazole and Tolterodine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Levoketoconazole belongs to Endocrine; Tolterodine belongs to Genitourinary.
Why it happens
Strong CYP3A4 inhibition reduces tolterodine clearance, with additive QT prolongation.
What to do
Do not exceed tolterodine 2 mg daily and monitor ECG and electrolytes, or choose an alternative to tolterodine.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Tolterodine
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 Tolterodine?
MediHelp rates the interaction as major. Levoketoconazole and Tolterodine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Levoketoconazole is a strong CYP3A4 inhibitor that raises tolterodine exposure. Both drugs prolong the QT interval, so the risk of arrhythmia and anticholinergic toxicity increases.
How serious is the interaction between Levoketoconazole and Tolterodine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not exceed tolterodine 2 mg daily and monitor ECG and electrolytes, or choose an alternative to tolterodine.
What other medicines interact with Tolterodine?
MediHelp also lists interactions of Tolterodine with, for example, Clarithromycin, Clozapine, Cobicistat. The full list is on the Tolterodine page.
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