Drug interactions
Artemether / lumefantrine + Clarithromycin
Severity: Major
Artemether / lumefantrine and Clarithromycin: 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
Clarithromycin inhibits CYP3A4, which metabolizes artemether and lumefantrine, increasing their exposure. Both antimalarial components and clarithromycin also prolong the QT interval, raising the risk of torsades de pointes.
What this interaction means in plain words
Artemether / lumefantrine and Clarithromycin 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.
Why it happens
CYP3A4 inhibition by clarithromycin combined with additive QT prolongation.
What to do
Avoid the combination where possible and use a non-macrolide antibiotic. If unavoidable, obtain an ECG, correct potassium and magnesium, and monitor cardiac status.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Artemether / lumefantrine and Clarithromycin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Frequently asked questions
Can I take Artemether / lumefantrine with Clarithromycin?
MediHelp rates the interaction as major. Artemether / lumefantrine and Clarithromycin 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. Clarithromycin inhibits CYP3A4, which metabolizes artemether and lumefantrine, increasing their exposure. Both antimalarial components and clarithromycin also prolong the QT interval, raising the risk of torsades de pointes.
How serious is the interaction between Artemether / lumefantrine and Clarithromycin?
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 the combination where possible and use a non-macrolide antibiotic. If unavoidable, obtain an ECG, correct potassium and magnesium, and monitor cardiac status.
What other medicines interact with Clarithromycin?
MediHelp also lists interactions of Clarithromycin with, for example, Astemizole, Avanafil, Cisapride. The full list is on the Clarithromycin page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
