Drug interactions
Erythromycin + Lumefantrine
Severity: Major
Erythromycin and Lumefantrine: major interaction.
Last updated Sources: UK SmPC
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 drugs prolong the QT interval, and erythromycin inhibits CYP3A4, which can raise lumefantrine exposure. The combination increases the risk of torsades de pointes, especially with electrolyte disturbances or other QT-prolonging drugs.
What this interaction means in plain words
Erythromycin 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 plus CYP3A4 inhibition by erythromycin reducing lumefantrine clearance.
What to do
Avoid the combination where possible and choose a non-QT-prolonging antibiotic. If unavoidable, obtain an ECG and correct potassium and magnesium first.
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 Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin Contraindicated
Frequently asked questions
Can I take Erythromycin with Lumefantrine?
MediHelp rates the interaction as major. Erythromycin 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. Both drugs prolong the QT interval, and erythromycin inhibits CYP3A4, which can raise lumefantrine exposure. The combination increases the risk of torsades de pointes, especially with electrolyte disturbances or other QT-prolonging drugs.
How serious is the interaction between Erythromycin 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: Avoid the combination where possible and choose a non-QT-prolonging antibiotic. If unavoidable, obtain an ECG and correct potassium and magnesium first.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin page.
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