Basic Information
ID DDInter1520 and DDInter1103
Interaction Artemether-lumefantrine may cause prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death.
Management Coadministration of artemether-lumefantrine with other drugs that can prolong the QT interval should generally be avoided. Caution is recommended when these drugs are used following treatment with artemether-lumefantrine due to the long elimination half-life of lumefantrine (3 to 6 days). Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope.
References [1] Cerner Multum, Inc. "Australian Product Information." O 0 [2] Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 [3] EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports. Available from: URL: http://www.ema.europa.eu/ema/index.jsp?curl=pages/includes/medicines/medicines_landingpage.jsp&mid." [4] "Product Information. Coartem (artemether-lumefantrine)." Novartis Pharmaceuticals, East Hanover, NJ. [5] Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 [6] Cerner Multum, Inc. "Australian Product Information." O 0 [7] "Product Information. Coartem (artemether-lumefantrine)." Novartis Pharmaceuticals, East Hanover, NJ. [8] Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm 66 (2009): 1438-67 [9] "Product Information. VFEND (voriconazole)." Pfizer U.S. Pharmaceuticals, New York, NY. [10] Cerner Multum, Inc. "Australian Product Information." O 0 [11] Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 [12] "Product Information. Coartem (artemether-lumefantrine)." Novartis Pharmaceuticals, East Hanover, NJ.
Alternative for Primaquine P01B
Artesunate Lumefantrine Artemether Pyrimethamine Tafenoquine Atovaquone
Proguanil Sulfadoxine
Alternative for Lumefantrine P01B
Artesunate Pyrimethamine Tafenoquine Atovaquone Primaquine Proguanil
Sulfadoxine
Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.