Drug interactions
Lefamulin + Mifepristone
Severity: Major
Lefamulin and Mifepristone: 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
Lefamulin is a CYP3A4 inhibitor and can raise mifepristone concentrations. Mifepristone (particularly the higher-dose Korlym regimen) can prolong the QT interval, so higher exposure raises the risk of serious ventricular arrhythmias.
What this interaction means in plain words
Lefamulin and Mifepristone 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.
Lefamulin belongs to Anti Bacterial; Mifepristone belongs to Endocrine.
Why it happens
Lefamulin inhibits CYP3A4-mediated metabolism of mifepristone, and both agents have QT-prolonging potential.
What to do
Avoid the combination where possible, particularly with oral lefamulin and chronic mifepristone therapy. If unavoidable, obtain a baseline ECG, correct potassium and magnesium, and monitor the QTc.
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 Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Other interactions of Lefamulin
- Lefamulin + Methadone Contraindicated
- Lefamulin + Pimavanserin Contraindicated
- Lefamulin + Pimozide Contraindicated
- Lefamulin + Quinidine Contraindicated
- Alfuzosin + Lefamulin Major
- Amiodarone + Lefamulin Major
Frequently asked questions
Can I take Lefamulin with Mifepristone?
MediHelp rates the interaction as major. Lefamulin and Mifepristone 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. Lefamulin is a CYP3A4 inhibitor and can raise mifepristone concentrations. Mifepristone (particularly the higher-dose Korlym regimen) can prolong the QT interval, so higher exposure raises the risk of serious ventricular arrhythmias.
How serious is the interaction between Lefamulin and Mifepristone?
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, particularly with oral lefamulin and chronic mifepristone therapy. If unavoidable, obtain a baseline ECG, correct potassium and magnesium, and monitor the QTc.
What other medicines interact with Mifepristone?
MediHelp also lists interactions of Mifepristone with, for example, Apixaban, Argatroban, Cisapride. The full list is on the Mifepristone page.
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