Drug interactions
Artemether / lumefantrine + Quinine
Severity: Major
Artemether / lumefantrine and Quinine: 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
Both quinine and lumefantrine prolong the QT interval, so combining them can increase the risk of serious ventricular arrhythmias. Lumefantrine's long half-life means the effect persists after the course ends, which is important when switching between antimalarials.
What this interaction means in plain words
Artemether / lumefantrine and Quinine 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 pharmacodynamic QT prolongation.
What to do
Avoid giving quinine soon after artemether/lumefantrine unless no alternative exists. If it must be used, obtain an ECG and monitor electrolytes and cardiac rhythm.
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 Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine Contraindicated
Frequently asked questions
Can I take Artemether / lumefantrine with Quinine?
MediHelp rates the interaction as major. Artemether / lumefantrine and Quinine 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. Both quinine and lumefantrine prolong the QT interval, so combining them can increase the risk of serious ventricular arrhythmias. Lumefantrine's long half-life means the effect persists after the course ends, which is important when switching between antimalarials.
How serious is the interaction between Artemether / lumefantrine and Quinine?
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 giving quinine soon after artemether/lumefantrine unless no alternative exists. If it must be used, obtain an ECG and monitor electrolytes and cardiac rhythm.
What other medicines interact with Quinine?
MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.
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