Drug interactions
Artemether / lumefantrine + Flecainide
Severity: Major
Artemether / lumefantrine and Flecainide: 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
Flecainide is cleared partly by CYP2D6, and lumefantrine inhibits CYP2D6. Higher flecainide exposure may follow, and artemether and lumefantrine can themselves prolong the QT interval. The result may be additive proarrhythmic risk.
What this interaction means in plain words
Artemether / lumefantrine and Flecainide 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
Lumefantrine inhibits CYP2D6, reducing flecainide clearance, combined with additive QT-prolonging effects.
What to do
Avoid the combination if an alternative is available. If it must be used, obtain an ECG before and during treatment, check electrolytes, and consider flecainide plasma concentration monitoring.
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 Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir Contraindicated
Frequently asked questions
Can I take Artemether / lumefantrine with Flecainide?
MediHelp rates the interaction as major. Artemether / lumefantrine and Flecainide 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. Flecainide is cleared partly by CYP2D6, and lumefantrine inhibits CYP2D6. Higher flecainide exposure may follow, and artemether and lumefantrine can themselves prolong the QT interval. The result may be additive proarrhythmic risk.
How serious is the interaction between Artemether / lumefantrine and Flecainide?
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 if an alternative is available. If it must be used, obtain an ECG before and during treatment, check electrolytes, and consider flecainide plasma concentration monitoring.
What other medicines interact with Flecainide?
MediHelp also lists interactions of Flecainide with, for example, Nirmatrelvir, Nirmatrelvir / ritonavir, Pimozide. The full list is on the Flecainide page.
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