Drug interactions
Levoketoconazole + Venlafaxine
Severity: Major
Levoketoconazole and Venlafaxine: 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 may raise venlafaxine exposure through inhibition of CYP3A4, a minor pathway for venlafaxine. Both drugs can also prolong the QT interval, so the combination adds arrhythmia risk, including torsades de pointes, particularly with other risk factors.
What this interaction means in plain words
Levoketoconazole and Venlafaxine 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; Venlafaxine belongs to Central Nervous System.
Why it happens
Strong CYP3A4 inhibition by levoketoconazole plus additive QT prolongation.
What to do
Obtain a baseline ECG and monitor QTc and electrolytes, correcting potassium and magnesium. Consider an alternative antidepressant if QTc becomes prolonged or other QT-prolonging drugs are present.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Levoketoconazole and Venlafaxine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Venlafaxine
- Isocarboxazid + Venlafaxine Contraindicated
- Methylene blue + Venlafaxine Contraindicated
- Phenelzine + Venlafaxine Contraindicated
- Procarbazine + Venlafaxine Contraindicated
- Rasagiline + Venlafaxine Contraindicated
- Safinamide + Venlafaxine 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 Venlafaxine?
MediHelp rates the interaction as major. Levoketoconazole and Venlafaxine 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 may raise venlafaxine exposure through inhibition of CYP3A4, a minor pathway for venlafaxine. Both drugs can also prolong the QT interval, so the combination adds arrhythmia risk, including torsades de pointes, particularly with other risk factors.
How serious is the interaction between Levoketoconazole and Venlafaxine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and monitor QTc and electrolytes, correcting potassium and magnesium. Consider an alternative antidepressant if QTc becomes prolonged or other QT-prolonging drugs are present.
What other medicines interact with Venlafaxine?
MediHelp also lists interactions of Venlafaxine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Venlafaxine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
