Drug interactions
Amiodarone + Efavirenz
Severity: Major
Amiodarone and Efavirenz: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Efavirenz may lower amiodarone levels through CYP3A4 induction, while both drugs can prolong the QT interval. The result is unpredictable antiarrhythmic effect with a risk of torsades de pointes.
What this interaction means in plain words
Amiodarone and Efavirenz can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Efavirenz belongs to Anti Virals.
Why it happens
Efavirenz induces CYP3A4 and both drugs have additive QT-prolonging effects.
What to do
Avoid if possible and consider alternative antiretrovirals. If used together, monitor ECG, electrolytes and amiodarone response.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir Contraindicated
Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Efavirenz?
MediHelp rates the interaction as major. Amiodarone and Efavirenz can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Efavirenz may lower amiodarone levels through CYP3A4 induction, while both drugs can prolong the QT interval. The result is unpredictable antiarrhythmic effect with a risk of torsades de pointes.
How serious is the interaction between Amiodarone and Efavirenz?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible and consider alternative antiretrovirals. If used together, monitor ECG, electrolytes and amiodarone response.
What other medicines interact with Efavirenz?
MediHelp also lists interactions of Efavirenz with, for example, Cobimetinib, Dienogest / estradiol valerate, Dihydroergotamine intranasal. The full list is on the Efavirenz page.
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