Drug interactions
Escitalopram + Mefloquine
Severity: Major
Escitalopram and Mefloquine: 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
Escitalopram prolongs the QT interval in a dose-dependent way, and mefloquine may add to this effect. Co-use raises the risk of torsades de pointes, particularly with other risk factors.
What this interaction means in plain words
Escitalopram and Mefloquine 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.
Escitalopram belongs to Central Nervous System; Mefloquine belongs to Anti Parasitic.
Why it happens
Additive QT prolongation via hERG blockade.
What to do
Prefer a different antimalarial. If both are needed, use the lowest effective escitalopram dose, check ECG and correct electrolytes.
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
- Lariam 250 mg tablets - SmPC sections 4.3/4.5 (class statement: selective serotonin reuptake inhibitors (SSRIs); "antidepressants such as tricyclic or selective serotonin reuptake inhibitors (SSRIs); bupropion; antipsychotics; tramadol; chloroquine or some antibiotics") — electronic medicines compendium (UK SmPC)
Other interactions of Mefloquine
- Arsenic trioxide + Mefloquine Contraindicated
- Dronedarone + Mefloquine Contraindicated
- Ibutilide + Mefloquine Contraindicated
- Levoketoconazole + Mefloquine Contraindicated
- Mefloquine + Nilotinib Contraindicated
- Mefloquine + Pimozide Contraindicated
Other interactions of Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Escitalopram with Mefloquine?
MediHelp rates the interaction as major. Escitalopram and Mefloquine 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. Escitalopram prolongs the QT interval in a dose-dependent way, and mefloquine may add to this effect. Co-use raises the risk of torsades de pointes, particularly with other risk factors.
How serious is the interaction between Escitalopram and Mefloquine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a different antimalarial. If both are needed, use the lowest effective escitalopram dose, check ECG and correct electrolytes.
What other medicines interact with Mefloquine?
MediHelp also lists interactions of Mefloquine with, for example, Arsenic trioxide, Dronedarone, Ibutilide. The full list is on the Mefloquine page.
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