Drug interactions
Artemether / lumefantrine + Pimavanserin
Severity: Major
Artemether / lumefantrine and Pimavanserin: major interaction.
Last updated Sources: US FDA label
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 pimavanserin adds to this effect, increasing the risk of torsades de pointes and sudden cardiac death. Lumefantrine has a long half-life, so exposure persists after the course ends.
What this interaction means in plain words
Artemether / lumefantrine and Pimavanserin 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 prolongation of cardiac repolarization (QTc).
What to do
Avoid if possible. If unavoidable, obtain an ECG, correct potassium and magnesium, and monitor for arrhythmia during and after the antimalarial course.
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 Pimavanserin
- Lefamulin + Pimavanserin Contraindicated
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin Major
Frequently asked questions
Can I take Artemether / lumefantrine with Pimavanserin?
MediHelp rates the interaction as major. Artemether / lumefantrine and Pimavanserin 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 pimavanserin adds to this effect, increasing the risk of torsades de pointes and sudden cardiac death. Lumefantrine has a long half-life, so exposure persists after the course ends.
How serious is the interaction between Artemether / lumefantrine and Pimavanserin?
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. If unavoidable, obtain an ECG, correct potassium and magnesium, and monitor for arrhythmia during and after the antimalarial course.
What other medicines interact with Pimavanserin?
MediHelp also lists interactions of Pimavanserin with, for example, Lefamulin, Pimozide, Vandetanib. The full list is on the Pimavanserin page.
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