Drug interactions
Artemether / lumefantrine + Clomipramine
Severity: Major
Artemether / lumefantrine and Clomipramine: 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
Lumefantrine is a CYP2D6 inhibitor and can raise levels of CYP2D6 substrates such as clomipramine. Both drugs can also prolong the QT interval, so the combination raises the risk of cardiac arrhythmia as well as tricyclic toxicity.
What this interaction means in plain words
Artemether / lumefantrine and Clomipramine 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
CYP2D6 inhibition by lumefantrine increases clomipramine exposure, with additive QT prolongation.
What to do
Avoid coadministration if possible; if the antimalarial is essential, obtain an ECG, correct electrolytes, and monitor for tricyclic toxicity.
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 Clomipramine
- Arsenic trioxide + Clomipramine Contraindicated
- Clomipramine + Dofetilide Contraindicated
- Clomipramine + Droperidol Contraindicated
- Clomipramine + Isocarboxazid Contraindicated
- Clomipramine + Methylene blue Contraindicated
- Clomipramine + Pentamidine Contraindicated
Frequently asked questions
Can I take Artemether / lumefantrine with Clomipramine?
MediHelp rates the interaction as major. Artemether / lumefantrine and Clomipramine 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. Lumefantrine is a CYP2D6 inhibitor and can raise levels of CYP2D6 substrates such as clomipramine. Both drugs can also prolong the QT interval, so the combination raises the risk of cardiac arrhythmia as well as tricyclic toxicity.
How serious is the interaction between Artemether / lumefantrine and Clomipramine?
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 coadministration if possible; if the antimalarial is essential, obtain an ECG, correct electrolytes, and monitor for tricyclic toxicity.
What other medicines interact with Clomipramine?
MediHelp also lists interactions of Clomipramine with, for example, Arsenic trioxide, Dofetilide, Droperidol. The full list is on the Clomipramine page.
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