Drug interactions
Clozapine + Lumefantrine
Severity: Major
Clozapine and Lumefantrine: 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 is a CYP3A4 substrate, and no meaningful induction of clozapine metabolism is established. Clozapine is chiefly metabolized by CYP1A2, with a smaller role for CYP3A4. Both drugs can prolong the QT interval, which is a more relevant concern than the enzyme effect.
What this interaction means in plain words
Clozapine and Lumefantrine 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; there is no established CYP-mediated effect on clozapine levels.
What to do
Obtain a baseline ECG and correct potassium and magnesium before treatment. Monitor the ECG during co-administration and avoid other QT-prolonging drugs.
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 Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
Frequently asked questions
Can I take Clozapine with Lumefantrine?
MediHelp rates the interaction as major. Clozapine and Lumefantrine 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 is a CYP3A4 substrate, and no meaningful induction of clozapine metabolism is established. Clozapine is chiefly metabolized by CYP1A2, with a smaller role for CYP3A4. Both drugs can prolong the QT interval, which is a more relevant concern than the enzyme effect.
How serious is the interaction between Clozapine and Lumefantrine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and correct potassium and magnesium before treatment. Monitor the ECG during co-administration and avoid other QT-prolonging drugs.
What other medicines interact with Clozapine?
MediHelp also lists interactions of Clozapine with, for example, Deferiprone, Irinotecan, Pimozide. The full list is on the Clozapine page.
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