Drug interactions
Levoketoconazole + Verapamil
Severity: Major
Levoketoconazole and Verapamil: 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 and can markedly raise verapamil concentrations, causing hypotension, bradycardia or AV block. Both drugs may also affect the QT interval or cardiac conduction.
What this interaction means in plain words
Levoketoconazole and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Strong CYP3A4 and P-gp inhibition by levoketoconazole reduces verapamil clearance.
What to do
Avoid if possible, or reduce the verapamil dose and monitor heart rate, blood pressure and ECG closely. Consider an alternative antihypertensive agent.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil 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 Verapamil?
MediHelp rates the interaction as major. Levoketoconazole and Verapamil 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 and can markedly raise verapamil concentrations, causing hypotension, bradycardia or AV block. Both drugs may also affect the QT interval or cardiac conduction.
How serious is the interaction between Levoketoconazole and Verapamil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible, or reduce the verapamil dose and monitor heart rate, blood pressure and ECG closely. Consider an alternative antihypertensive agent.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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