Drug interactions
Fexinidazole + Primaquine
Severity: Major
Fexinidazole and Primaquine: 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
Fexinidazole carries a QT prolongation warning, and primaquine can add to this effect, raising the risk of serious ventricular arrhythmia. Fexinidazole may also inhibit CYP3A4 and raise primaquine exposure, but the QT concern is the main issue.
What this interaction means in plain words
Fexinidazole and Primaquine 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, with possible CYP3A4 inhibition by fexinidazole increasing primaquine exposure.
What to do
Avoid the combination where possible and use an alternative antimalarial. If it cannot be avoided, check the ECG and electrolytes at baseline and monitor the QTc and for primaquine adverse effects.
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 Primaquine
- Pimozide + Primaquine Contraindicated
- Amiodarone + Primaquine Major
- Amisulpride + Primaquine Major
- Anagrelide + Primaquine Major
- Arsenic trioxide + Primaquine Major
- Asenapine + Primaquine Major
Frequently asked questions
Can I take Fexinidazole with Primaquine?
MediHelp rates the interaction as major. Fexinidazole and Primaquine 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. Fexinidazole carries a QT prolongation warning, and primaquine can add to this effect, raising the risk of serious ventricular arrhythmia. Fexinidazole may also inhibit CYP3A4 and raise primaquine exposure, but the QT concern is the main issue.
How serious is the interaction between Fexinidazole and Primaquine?
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 use an alternative antimalarial. If it cannot be avoided, check the ECG and electrolytes at baseline and monitor the QTc and for primaquine adverse effects.
What other medicines interact with Primaquine?
MediHelp also lists interactions of Primaquine with, for example, Pimozide, Amiodarone, Amisulpride. The full list is on the Primaquine page.
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