Drug interactions
Lefamulin + Quinine
Severity: Major
Lefamulin and Quinine: 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 inhibits CYP3A4, the main pathway of quinine metabolism, and both drugs prolong the QT interval. Combined use increases the risk of torsades de pointes.
What this interaction means in plain words
Lefamulin and Quinine 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; Quinine belongs to Anti Parasitic.
Why it happens
CYP3A4 inhibition raising quinine levels plus additive QT prolongation.
What to do
Avoid the combination; use an alternative antibiotic or, if unavoidable, monitor ECG and 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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Other interactions of Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine 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 Quinine?
MediHelp rates the interaction as major. Lefamulin and Quinine 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 inhibits CYP3A4, the main pathway of quinine metabolism, and both drugs prolong the QT interval. Combined use increases the risk of torsades de pointes.
How serious is the interaction between Lefamulin and Quinine?
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; use an alternative antibiotic or, if unavoidable, monitor ECG and electrolytes.
What other medicines interact with Quinine?
MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.
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