Drug interactions
Artemether / lumefantrine + Nevirapine
Severity: Major
Artemether / lumefantrine and Nevirapine: major interaction.
Last updated Sources: UK SmPC
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
Nevirapine induces CYP3A4 and can lower artemether and lumefantrine exposure, risking antimalarial treatment failure. Lumefantrine and artemether levels, and the active metabolite dihydroartemisinin, may all fall.
What this interaction means in plain words
Artemether / lumefantrine and Nevirapine 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
Nevirapine induces CYP3A4, accelerating metabolism of artemether and lumefantrine.
What to do
Where possible avoid the combination or monitor closely for malaria treatment failure, with follow-up parasitological assessment. Consider an alternative antimalarial regimen if feasible.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
Frequently asked questions
Can I take Artemether / lumefantrine with Nevirapine?
MediHelp rates the interaction as major. Artemether / lumefantrine and Nevirapine 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. Nevirapine induces CYP3A4 and can lower artemether and lumefantrine exposure, risking antimalarial treatment failure. Lumefantrine and artemether levels, and the active metabolite dihydroartemisinin, may all fall.
How serious is the interaction between Artemether / lumefantrine and Nevirapine?
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 avoid the combination or monitor closely for malaria treatment failure, with follow-up parasitological assessment. Consider an alternative antimalarial regimen if feasible.
What other medicines interact with Nevirapine?
MediHelp also lists interactions of Nevirapine with, for example, Elbasvir / grazoprevir, Ranolazine, St john's wort. The full list is on the Nevirapine page.
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