Drug interactions
Artemether / lumefantrine + Perphenazine
Severity: Major
Artemether / lumefantrine and Perphenazine: major interaction.
Last updated Sources: Health Canada product monograph
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
Artemether/lumefantrine can prolong the QT interval, and perphenazine adds to this effect. Perphenazine is also metabolized by CYP2D6, which lumefantrine inhibits, potentially raising its levels.
What this interaction means in plain words
Artemether / lumefantrine and Perphenazine 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, with possible CYP2D6 inhibition raising perphenazine concentrations.
What to do
Avoid if possible, or use an alternative antimalarial or antipsychotic. If coadministered, obtain an ECG and monitor electrolytes and for perphenazine adverse effects.
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 Perphenazine
- Ibutilide + Perphenazine Contraindicated
- Perphenazine + Pimozide Contraindicated
- Perphenazine + Thioridazine Contraindicated
- Adagrasib + Perphenazine Major
- Alfentanil + Perphenazine Major
- Amiodarone + Perphenazine Major
Frequently asked questions
Can I take Artemether / lumefantrine with Perphenazine?
MediHelp rates the interaction as major. Artemether / lumefantrine and Perphenazine 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. Artemether/lumefantrine can prolong the QT interval, and perphenazine adds to this effect. Perphenazine is also metabolized by CYP2D6, which lumefantrine inhibits, potentially raising its levels.
How serious is the interaction between Artemether / lumefantrine and Perphenazine?
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 if possible, or use an alternative antimalarial or antipsychotic. If coadministered, obtain an ECG and monitor electrolytes and for perphenazine adverse effects.
What other medicines interact with Perphenazine?
MediHelp also lists interactions of Perphenazine with, for example, Ibutilide, Pimozide, Thioridazine. The full list is on the Perphenazine page.
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