Drug interactions
Artemether / lumefantrine + Propafenone
Severity: Major
Artemether / lumefantrine and Propafenone: 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
Lumefantrine inhibits CYP2D6 and both antimalarial components can prolong the QT interval. Propafenone is metabolized by CYP2D6 and is itself proarrhythmic, so higher propafenone exposure and additive QT effects may increase the risk of serious arrhythmia.
What this interaction means in plain words
Artemether / lumefantrine and Propafenone 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
CYP2D6 inhibition by lumefantrine raises propafenone levels, with additive effects on cardiac repolarization and conduction.
What to do
Avoid the combination if possible and use another antimalarial. If unavoidable, monitor ECG and electrolytes and consider reducing the propafenone dose.
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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
Frequently asked questions
Can I take Artemether / lumefantrine with Propafenone?
MediHelp rates the interaction as major. Artemether / lumefantrine and Propafenone 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. Lumefantrine inhibits CYP2D6 and both antimalarial components can prolong the QT interval. Propafenone is metabolized by CYP2D6 and is itself proarrhythmic, so higher propafenone exposure and additive QT effects may increase the risk of serious arrhythmia.
How serious is the interaction between Artemether / lumefantrine and Propafenone?
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 the combination if possible and use another antimalarial. If unavoidable, monitor ECG and electrolytes and consider reducing the propafenone dose.
What other medicines interact with Propafenone?
MediHelp also lists interactions of Propafenone with, for example, Dofetilide, Dronedarone, Nilotinib. The full list is on the Propafenone page.
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