Drug interactions
Artemether / lumefantrine + Clozapine
Severity: Major
Artemether / lumefantrine and Clozapine: major interaction.
Last updated Sources: UK SmPC
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
Both artemether/lumefantrine and clozapine can prolong the QTc interval, increasing the risk of torsades de pointes and sudden death. Artemether/lumefantrine labeling warns against use with other QT-prolonging drugs.
What this interaction means in plain words
Artemether / lumefantrine and Clozapine 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
Additive QT prolongation.
What to do
Avoid the combination where an alternative antimalarial exists. If unavoidable, obtain an ECG and correct potassium and magnesium before and during treatment.
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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References
- Clozapine Viatris 100 mg Orodispersible Tablets - SmPC sections 4.3/4.5 (class statement: medicines known to increase QTc interval; "caution should be exercised when clozapine is prescribed with medicines known to increase QTc interval, or causing electrolyte imbalance.") — electronic medicines compendium (UK SmPC)
Other interactions of Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
Frequently asked questions
Can I take Artemether / lumefantrine with Clozapine?
MediHelp rates the interaction as major. Artemether / lumefantrine and Clozapine 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. Both artemether/lumefantrine and clozapine can prolong the QTc interval, increasing the risk of torsades de pointes and sudden death. Artemether/lumefantrine labeling warns against use with other QT-prolonging drugs.
How serious is the interaction between Artemether / lumefantrine and Clozapine?
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 an alternative antimalarial exists. If unavoidable, obtain an ECG and correct potassium and magnesium before and during treatment.
What other medicines interact with Clozapine?
MediHelp also lists interactions of Clozapine with, for example, Deferiprone, Irinotecan, Pimozide. The full list is on the Clozapine page.
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