Drug Interaction Report

Consumer information for this interaction is not currently available.

CONTRAINDICATED: Levoketoconazole can cause concentration-dependent, life-threatening prolongation of the QT interval. Coadministration with other agents that can prolong the QT interval may increase the risk of ventricular arrhythmias including torsade de pointes and sudden death. According to cardiac electrophysiology data provided by the prescribing information, the largest mean increase in QTc was 24 msec following administration of levoketoconazole 150 mg to 600 mg twice daily in patients with endogenous Cushing's syndrome, and the increase was dose-related. During two premarketing levoketoconazole clinical studies, 4 (2.4%) patients experienced QTcF greater than 500 msec, and 23 (14.7%) patients presented a change in QTcF greater than 60 msec from baseline. The clinical studies did not include patients with baseline QTcF interval greater than 470 msec. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s).

MANAGEMENT: Coadministration of levoketoconazole with other drugs that can prolong the QT interval is considered contraindicated.

You should avoid the use of alcohol while being treated with levoketoconazole. Levoketoconazole may cause liver damage and using it with alcohol or products containing alcohol may increase that risk. In addition, consumption of alcoholic beverages or products containing alcohol during treatment with levoketoconazole may trigger a disulfiram-like reaction in some patients, with unpleasant symptoms such as flushing, palpitations, and nausea. Levoketoconazole may be taken with or without food. You should avoid consumption of grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with levoketoconazole unless directed otherwise by your doctor. Grapefruit juice may increase the blood levels of levoketoconazole. This may increase the risk and/or severity of side effects and liver problems. You should seek immediate medical attention if you develop signs and symptoms of liver damage during treatment with levoketoconazole, such as joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and yellowing of the skin or eyes. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.