Drug interactions
Artemether / lumefantrine + Fluconazole
Severity: Major
Artemether / lumefantrine and Fluconazole: 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
Both drugs can prolong the QT interval, and fluconazole also inhibits CYP3A4, which metabolizes lumefantrine and artemether. The combination increases the risk of torsades de pointes.
What this interaction means in plain words
Artemether / lumefantrine and Fluconazole 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 plus fluconazole inhibition of CYP3A4 metabolism of lumefantrine.
What to do
Avoid unless the benefit outweighs the risk. If both are needed, obtain an ECG, correct electrolytes and monitor for arrhythmia.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Frequently asked questions
Can I take Artemether / lumefantrine with Fluconazole?
MediHelp rates the interaction as major. Artemether / lumefantrine and Fluconazole 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 drugs can prolong the QT interval, and fluconazole also inhibits CYP3A4, which metabolizes lumefantrine and artemether. The combination increases the risk of torsades de pointes.
How serious is the interaction between Artemether / lumefantrine and Fluconazole?
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 unless the benefit outweighs the risk. If both are needed, obtain an ECG, correct electrolytes and monitor for arrhythmia.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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