Has your doctor told you or someone in your family has Cushing's Disease? Perhaps because surgery didn't completely cure it, or because surgery is not possible, your doctor may have prescribed you a medication called Levoketoconazole. The brand name for this medication is Recorlev. So, to clear up any doubts or fears you may have about this medication, let's talk about it in detail and in a very simple way.
What exactly is Levoketoconazole?
Simply put, Levoketoconazole is a medication used to treat Cushing's Disease. Cushing's disease is a condition caused by the adrenal glands in our body producing too much of the hormone cortisol. This medication works by controlling the production of that excess cortisol hormone.
This medication is often given to those who cannot undergo surgery, or to those whose disease is not controlled after surgery. This is a medication that should be used only under the supervision of a doctor.
Things you should tell your doctor before taking medication
Your doctor will need to know your complete health history before deciding if this medication is right for you and if it is safe. Therefore, if you have any of the conditions listed below, be sure to tell your doctor about it.
- Heart disease: If you have any heart disease, an irregular heartbeat, or a problem with the QT interval.
- Liver Disease: If you have any liver disease.
- Bleeding Disorder: If there is a problem where the blood does not clot easily.
- Low Adrenal Gland Function: If your doctor has told you about this condition.
- Blood mineral levels: If you have been told that your blood levels of potassium or magnesium are low.
- Low Stomach Acid: If you know that your stomach acid is low.
- Alcohol use: If you are a regular drinker.
- Pregnancy or planning to become pregnant: If you are pregnant, trying to become pregnant, or breastfeeding.
- Allergies: If you have an allergy to Levoketoconazole, Ketoconazole, or any other medicine, food, or dye, you should also disclose it.
The correct way to use the medicine
- This medicine is to be taken orally as a pill. Take it exactly as prescribed by your doctor, at the right time, and in the right dosage.
- You can take this with or without food. However, if you experience stomach discomfort, it is best to take it with a meal .
- Continue taking this medicine until your doctor tells you to stop. Do not stop it at your own discretion.
- Very important: Do not take any medications for gastritis or stomach ulcers, such as antacids, for at least two hours after taking this Levoketoconazole tablet. These medications may reduce the absorption of Levoketoconazole.
What if I miss a dose of medication?
Don't worry. If you miss a dose, skip it altogether. Take your next dose at the usual time. Do not take two doses at once to make up for a missed dose.
What if I take too much medicine?
If you suspect that you have taken more medicine than you think, call the National Poisons Information Centre at the Colombo National Hospital immediately. Or, go to the Emergency Treatment Unit (ETU) of the nearest hospital. This medicine has been prescribed for you only, so do not share it with others.
Other drugs that may interact with levoketoconazole (Drug Interactions)
This is something to be very careful about. Levoketoconazole is a drug that can interact with a number of other medications. Therefore, it is essential to tell your doctor about all the medications you are taking (including vitamins, herbal remedies, and supplements).
| Medications that should never be taken with levoketoconazole | |
|---|---|
| Drug category | Examples |
| Some medications for anxiety or sleep | Alprazolam, Triazolam |
| Some medications for cholesterol | Cerivastatin, Lovastatin, Simvastatin, Lomitapide |
| Medication for irregular heartbeat | Disopyramide, Dofetilide, Dronedarone, Quinidine |
| Ergot class drugs | Dihydroergotamine, Ergotamine |
| Other | Cisapride, Colchicine, Methadone, Pimozide, Ranolazine, Sirolimus, Tolvaptan, Red yeast rice |
The medications listed above can cause very serious side effects when taken together with Levoketoconazole. Therefore, these should definitely not be taken together.
| Other drugs that may cause problems with levoketoconazole | |
|---|---|
| Alcohol, HIV/AIDS medications, steroids (e.g. Dexamethasone), Metformin for diabetes, Amlodipine, Nifedipine for blood pressure, Warfarin, Rivaroxaban for blood clotting, Atorvastatin for cholesterol, Rifampin, Isoniazid for tuberculosis. | |
| Also, many other medications used to treat cancer, depression, seizures , pain, and stomach problems can interact with this. | |
This list is not complete, so tell your doctor about all medications and supplements you take.
Possible side effects while taking the medicine
Like any medicine, this medicine can cause some side effects. However, not everyone gets them. Some are serious, while others are mild.
| Side effect | Description |
|---|---|
| Serious side effects that require immediate medical attention | |
| Symptoms of liver damage | Pain in the upper right side of the stomach, loss of appetite, nausea, yellowing of the skin or eyes, dark yellow/brown urine, pale stools. |
| Changes in heart rate | Difficulty breathing, chest pain, dizziness, rapid heartbeat, feeling faint. |
| Decreased adrenal function | Nausea, vomiting, loss of appetite, extreme fatigue, dizziness. |
| Allergic Reactions | Skin rash, itching, swelling of the face, lips, tongue. |
| Abnormal bleeding | Black stools, vomit that looks like coffee grounds, red/dark brown urine, red/purple spots on the skin. |
| Side effects that are usually not serious, but should be reported to your doctor if they are bothersome | |
| Headache | Nausea and vomiting |
| Stomach pain | Stomach discomfort |
Other things to keep in mind while taking the medicine
- Regular check-ups: You will need to see your doctor regularly to monitor your condition while taking this medicine. You will also need to have regular blood tests to check things like liver function. Do not skip any of these tests.
- Alcohol: Limit alcohol consumption completely while taking this medication. Alcohol can increase liver damage.
- Fertility: This medicine may temporarily affect your ability to have children. If you have any concerns about this, talk to your doctor.
- Breastfeeding: Do not breastfeed while taking this medicine and for 1 day after stopping the medicine.
Take-Home Message
- Levoketoconazole is a special medication for Cushing's disease that must be taken under the supervision of a doctor.
- It is essential to inform your doctor about all other medications (including vitamins) you are taking.
- Seek immediate medical attention if you experience any serious side effects, such as pain on the right side of your stomach, yellowing of the eyes, or changes in your heart rate.
- Never stop taking medication or change the dosage without your doctor's advice.
- Be sure to attend scheduled medical checkups and blood tests.
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