Drug interactions
Indinavir + Mefloquine
Severity: Major
Indinavir and Mefloquine: 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
Indinavir inhibits CYP3A4 and may increase mefloquine concentrations. This can heighten neuropsychiatric and cardiac toxicity, and the risk persists because of mefloquine's prolonged elimination.
What this interaction means in plain words
Indinavir 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.
Why it happens
CYP3A4 inhibition by indinavir decreases mefloquine metabolism.
What to do
Avoid the combination and use another antimalarial. If unavoidable, monitor the ECG and neuropsychiatric symptoms.
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 Mefloquine
- Arsenic trioxide + Mefloquine Contraindicated
- Dronedarone + Mefloquine Contraindicated
- Ibutilide + Mefloquine Contraindicated
- Levoketoconazole + Mefloquine Contraindicated
- Mefloquine + Nilotinib Contraindicated
- Mefloquine + Pimozide Contraindicated
Frequently asked questions
Can I take Indinavir with Mefloquine?
MediHelp rates the interaction as major. Indinavir 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. Indinavir inhibits CYP3A4 and may increase mefloquine concentrations. This can heighten neuropsychiatric and cardiac toxicity, and the risk persists because of mefloquine's prolonged elimination.
How serious is the interaction between Indinavir 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: Avoid the combination and use another antimalarial. If unavoidable, monitor the ECG and neuropsychiatric symptoms.
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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