Drug interactions
Levoketoconazole + Tolvaptan
Severity: Contraindicated
Levoketoconazole and Tolvaptan: 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 inhibitor and markedly raises tolvaptan exposure. Strong CYP3A inhibitors are contraindicated with tolvaptan because of the risk of overly rapid sodium correction and other toxicity.
What this interaction means in plain words
Levoketoconazole and Tolvaptan 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; Tolvaptan belongs to Endocrine.
Why it happens
Levoketoconazole strongly inhibits CYP3A4, greatly reducing tolvaptan clearance.
What to do
Do not coadminister. Use an alternative therapy for one of the conditions.
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?
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Other interactions of Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan 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 Tolvaptan?
MediHelp rates the interaction as contraindicated. Levoketoconazole and Tolvaptan 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 inhibitor and markedly raises tolvaptan exposure. Strong CYP3A inhibitors are contraindicated with tolvaptan because of the risk of overly rapid sodium correction and other toxicity.
How serious is the interaction between Levoketoconazole and Tolvaptan?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not coadminister. Use an alternative therapy for one of the conditions.
What other medicines interact with Tolvaptan?
MediHelp also lists interactions of Tolvaptan with, for example, Atazanavir, Ceritinib, Cobicistat. The full list is on the Tolvaptan page.
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