Drug interactions
Levoketoconazole + Zonisamide
Severity: Moderate
Levoketoconazole and Zonisamide: moderate 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 raise zonisamide concentrations. This may cause increased somnolence, dizziness, and other dose-related toxicity.
What this interaction means in plain words
Levoketoconazole and Zonisamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Levoketoconazole belongs to Endocrine; Zonisamide belongs to Central Nervous System.
Why it happens
Strong inhibition of CYP3A4-mediated zonisamide metabolism.
What to do
Monitor for zonisamide toxicity and consider reducing its dose while levoketoconazole is used. Recheck tolerability when levoketoconazole is stopped.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Zonisamide
- Zonisamide + Zuranolone Major
- Acetazolamide + Zonisamide Moderate
- Amisulpride + Zonisamide Moderate
- Amobarbital + Zonisamide Moderate
- Apalutamide + Zonisamide Moderate
- Asenapine transdermal + Zonisamide Moderate
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 Zonisamide?
MediHelp rates the interaction as moderate. Levoketoconazole and Zonisamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Levoketoconazole is a strong CYP3A4 inhibitor and can raise zonisamide concentrations. This may cause increased somnolence, dizziness, and other dose-related toxicity.
How serious is the interaction between Levoketoconazole and Zonisamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for zonisamide toxicity and consider reducing its dose while levoketoconazole is used. Recheck tolerability when levoketoconazole is stopped.
What other medicines interact with Zonisamide?
MediHelp also lists interactions of Zonisamide with, for example, Zuranolone, Acetazolamide, Amisulpride. The full list is on the Zonisamide page.
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