Drug interactions
Artemether / lumefantrine + Mexiletine
Severity: Moderate
Artemether / lumefantrine and Mexiletine: moderate 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
Lumefantrine inhibits CYP2D6, one of the pathways metabolizing mexiletine, so mexiletine levels may increase. Mexiletine has a narrow therapeutic index, with neurological and cardiac toxicity at high concentrations. Both drugs may also affect QT interval or conduction.
What this interaction means in plain words
Artemether / lumefantrine and Mexiletine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Lumefantrine inhibits CYP2D6-mediated mexiletine metabolism, and both drugs have additive cardiac conduction effects.
What to do
Monitor ECG and for mexiletine toxicity (tremor, dizziness, nausea) during the short antimalarial course and reduce the mexiletine dose if symptoms appear.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Artemether / lumefantrine and Mexiletine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Mexiletine
- Fezolinetant + Mexiletine Contraindicated
- Mexiletine + Pimozide Contraindicated
- Alosetron + Mexiletine Major
- Amiodarone + Mexiletine Major
- Clozapine + Mexiletine Major
- Cobicistat + Mexiletine Major
Frequently asked questions
Can I take Artemether / lumefantrine with Mexiletine?
MediHelp rates the interaction as moderate. Artemether / lumefantrine and Mexiletine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Lumefantrine inhibits CYP2D6, one of the pathways metabolizing mexiletine, so mexiletine levels may increase. Mexiletine has a narrow therapeutic index, with neurological and cardiac toxicity at high concentrations. Both drugs may also affect QT interval or conduction.
How serious is the interaction between Artemether / lumefantrine and Mexiletine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG and for mexiletine toxicity (tremor, dizziness, nausea) during the short antimalarial course and reduce the mexiletine dose if symptoms appear.
What other medicines interact with Mexiletine?
MediHelp also lists interactions of Mexiletine with, for example, Fezolinetant, Pimozide, Alosetron. The full list is on the Mexiletine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
