Drug interactions
Levoketoconazole + Vinblastine
Severity: Major
Levoketoconazole and Vinblastine: 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 also inhibits P-gp, so it can greatly increase vinblastine exposure. Severe myelosuppression, neurotoxicity and ileus are possible.
What this interaction means in plain words
Levoketoconazole and Vinblastine 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; Vinblastine belongs to Oncology.
Why it happens
Levoketoconazole inhibits CYP3A4 and P-gp, reducing vinblastine metabolism and efflux.
What to do
Avoid if possible; otherwise reduce the vinblastine dose and monitor blood counts and neurologic and bowel function closely.
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 Vinblastine
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 Vinblastine?
MediHelp rates the interaction as major. Levoketoconazole and Vinblastine 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 also inhibits P-gp, so it can greatly increase vinblastine exposure. Severe myelosuppression, neurotoxicity and ileus are possible.
How serious is the interaction between Levoketoconazole and Vinblastine?
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; otherwise reduce the vinblastine dose and monitor blood counts and neurologic and bowel function closely.
What other medicines interact with Vinblastine?
MediHelp also lists interactions of Vinblastine with, for example, Adenovirus types 4 and 7 live, Apalutamide, Atazanavir. The full list is on the Vinblastine page.
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