Drug interactions
Artemether / lumefantrine + Methadone
Severity: Major
Artemether / lumefantrine and Methadone: 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 artemether/lumefantrine and methadone can prolong the QT interval, so the combination raises arrhythmia risk. Artemether may also induce CYP3A4 and lower methadone levels, potentially causing withdrawal, although the short treatment course limits this.
What this interaction means in plain words
Artemether / lumefantrine and Methadone 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 possible CYP3A4 induction by artemether lowering methadone exposure.
What to do
Obtain an ECG before and during treatment if the combination cannot be avoided, and correct electrolytes. Monitor for opioid withdrawal and consider an alternative antimalarial if QTc is prolonged.
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 Methadone
- Alvimopan + Methadone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Methadone Contraindicated
- Droperidol + Methadone Contraindicated
- Ibutilide + Methadone Contraindicated
- Isocarboxazid + Methadone Contraindicated
- Lefamulin + Methadone Contraindicated
Frequently asked questions
Can I take Artemether / lumefantrine with Methadone?
MediHelp rates the interaction as major. Artemether / lumefantrine and Methadone 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 methadone can prolong the QT interval, so the combination raises arrhythmia risk. Artemether may also induce CYP3A4 and lower methadone levels, potentially causing withdrawal, although the short treatment course limits this.
How serious is the interaction between Artemether / lumefantrine and Methadone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain an ECG before and during treatment if the combination cannot be avoided, and correct electrolytes. Monitor for opioid withdrawal and consider an alternative antimalarial if QTc is prolonged.
What other medicines interact with Methadone?
MediHelp also lists interactions of Methadone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Droperidol. The full list is on the Methadone page.
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