What the FDA labels say about taking them together
Ketoconazole and levomilnacipran
Levomilnacipran's FDA label of April 30, 2024 names ketoconazole in its drug interactions section; the ketoconazole label PlainMeds reads does not name levomilnacipran. The levomilnacipran label: “Concomitant use of FETZIMA with strong CYP3A4 inhibitors increases levomilnacipran exposure.”
Check it at the source: the ketoconazole FDA label on DailyMed (effective January 28, 2026, E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC); the levomilnacipran FDA label on DailyMed (effective April 30, 2024, Allergan, Inc.).
What does the ketoconazole label say about levomilnacipran?
Ketoconazole's label (effective January 28, 2026) does not name levomilnacipran in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (ketoconazole), E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC, effective January 28, 2026 (SPL set cad7c647-34a9-4e4e-83b3-8d78e58f588f), via openFDA; the full label on DailyMed
What does the levomilnacipran label say about ketoconazole?
Levomilnacipran label, drug interactionsStrong CYP3A4 Inhibitors Clinical Impact: Concomitant use of FETZIMA with strong CYP3A4 inhibitors increases levomilnacipran exposure. Intervention: The dose of FETZIMA should not exceed 80 mg once daily when used with strong CYP3A4 inhibitors [see Dosage and Administration (). Examples: Ketoconazole, itraconazole, clarithromycin
Source: FDA drug label (Fetzima), NDA204168 (Abbvie), as published by Allergan, Inc., effective April 30, 2024 (SPL set f371258d-91b3-4b6a-ac99-434a1964c3af), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Ketoconazole | Levomilnacipran | |
|---|---|---|
| Labeled for | Fungal infections | Depression |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $0.249 per gram 2% cream | $17.61 per unit 20-40 mg titration pak |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once