Drug interactions
Levoketoconazole + Zolpidem
Severity: Major
Levoketoconazole and Zolpidem: 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 substantially raise zolpidem exposure. This increases the risk of profound sedation, confusion, falls and complex sleep behaviours. Ketoconazole has been shown to increase zolpidem exposure.
What this interaction means in plain words
Levoketoconazole and Zolpidem 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; Zolpidem belongs to Central Nervous System.
Why it happens
Strong CYP3A4 inhibition reduces zolpidem clearance and increases its plasma concentrations.
What to do
Use a reduced zolpidem dose (for example 5 mg or lower) or choose a non-CYP3A4 hypnotic. Monitor for excessive sedation and psychomotor impairment.
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 Zolpidem
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 Zolpidem?
MediHelp rates the interaction as major. Levoketoconazole and Zolpidem 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 substantially raise zolpidem exposure. This increases the risk of profound sedation, confusion, falls and complex sleep behaviours. Ketoconazole has been shown to increase zolpidem exposure.
How serious is the interaction between Levoketoconazole and Zolpidem?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a reduced zolpidem dose (for example 5 mg or lower) or choose a non-CYP3A4 hypnotic. Monitor for excessive sedation and psychomotor impairment.
What other medicines interact with Zolpidem?
MediHelp also lists interactions of Zolpidem with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Benzhydrocodone / acetaminophen. The full list is on the Zolpidem page.
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