Levoketoconazole

Adult Medication
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This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Recorlev

Warning
  • Severe liver problems have happened with ketoconazole, a drug like this one. Sometimes, this was deadly or led to a liver transplant. Some people did not already have a raised chance of liver problems. You will need blood tests before and while you take this drug. If you have ever had liver problems, raised liver enzymes, or gallstones, talk with your doctor. This drug may not be right for you.
  • Call your doctor right away if you have signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • A type of abnormal heartbeat (prolonged QT interval) has happened with this drug. This can be life-threatening and may lead to another type of severe abnormal heartbeat (torsades de pointes). Call your doctor right away if you have a fast or abnormal heartbeat, dizziness, or if you pass out.
  • Have your blood work checked and an ECG (to see how your heart beats) as you have been told by your doctor.
  • Do not take this drug if you are taking certain other drugs, including any drugs that can raise the chance of a prolonged QT interval (a type of heartbeat that is not normal). There are many drugs that interact with this drug. Talk with your doctor and pharmacist to make sure it is safe to take this drug with all of your drugs.
  • If a family member has a long QT on ECG or if you have ever had a prolonged QT interval or other abnormal heartbeat, talk with your doctor. This drug may not be right for you.

What is this drug used for?

  • It is used to treat high cortisol levels in people with Cushing’s syndrome.

What do I need to tell my doctor BEFORE I take this drug?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have any of these health problems: Low potassium or magnesium levels.
  • If you take any drugs (prescription or OTC, natural products, vitamins) that must not be taken with this drug, like some other drugs used for HIV or certain drugs used for seizures, infection, or stomach or bowel problems. There are many drugs that must not be taken with this drug.
  • If you are taking any drugs that can raise the chance of liver problems. There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure.
  • If you are breast-feeding. Do not breast-feed while you take this drug and for 1 day after your last dose.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Have your urine checked as you have been told by your doctor.
  • Talk with your doctor before you drink alcohol.
  • This drug may affect fertility. Fertility problems may lead to not being able to get pregnant or father a child. If you plan to get pregnant or father a child, talk with your doctor before taking this drug.
  • Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this drug while you are pregnant.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of low potassium levels like muscle pain or weakness, muscle cramps, or a heartbeat that does not feel normal.
  • Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
  • Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
  • Signs of a urinary tract infection (UTI) like blood in the urine, burning or pain when passing urine, feeling the need to pass urine often or right away, fever, lower stomach pain, or pelvic pain.
  • Swelling in the arms or legs.
  • Depression.
  • This drug may lower testosterone levels. This may cause enlarged breasts, low sperm counts, lowered interest in sex, mood changes, and not being able to get an erection. Call your doctor if any of these effects occur.
  • This drug can cause very low cortisol levels. Sometimes, this can lead to low blood pressure, electrolyte problems, low blood sugar, or life-threatening adrenal gland problems. Call your doctor right away if you have severe stomach pain, upset stomach, or throwing up; dizziness or passing out; fast or abnormal heartbeat; headache; mood changes; confusion; muscle pain or weakness; seizures; shakiness; sweating; feeling very sleepy, tired, or weak; or appetite changes.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Diarrhea, stomach pain, upset stomach, throwing up, or decreased appetite.
  • Headache.
  • Feeling dizzy, tired, or weak.
  • Signs of a common cold.
  • Dry mouth.
  • Dry skin.
  • Hair loss.
  • Back, muscle, or joint pain.
  • Trouble sleeping.
  • Not able to focus.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • Take with or without food.
  • If you take antacids, take this drug at least 2 hours before you take the antacids.
  • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.

What do I do if I miss a dose?

  • Skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

  • Store at room temperature in a dry place. Do not store in a bathroom.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2023-07-03

Copyright

© 2024 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

Last Updated

Monday, December 12, 2022