Drug interactions
Artemether / lumefantrine + Efavirenz
Severity: Major
Artemether / lumefantrine and Efavirenz: major interaction.
Last updated Sources: US FDA label
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 lowers artemether and lumefantrine exposure through enzyme induction, which may cause malaria treatment failure. Both agents also prolong the QT interval, adding arrhythmia risk.
What this interaction means in plain words
Artemether / lumefantrine 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.
Why it happens
CYP3A4 induction by efavirenz reduces antimalarial concentrations, with additive QT prolongation.
What to do
Where possible use an alternative antimalarial or antiretroviral. If coadministered, check ECG and electrolytes and monitor closely for treatment failure and recurrence of parasitemia.
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
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
Frequently asked questions
Can I take Artemether / lumefantrine with Efavirenz?
MediHelp rates the interaction as major. Artemether / lumefantrine 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 lowers artemether and lumefantrine exposure through enzyme induction, which may cause malaria treatment failure. Both agents also prolong the QT interval, adding arrhythmia risk.
How serious is the interaction between Artemether / lumefantrine 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: Where possible use an alternative antimalarial or antiretroviral. If coadministered, check ECG and electrolytes and monitor closely for treatment failure and recurrence of parasitemia.
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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