Drug interactions
Lefamulin + Ranolazine
Severity: Major
Lefamulin and Ranolazine: 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 and prolongs the QT interval, so it can raise ranolazine concentrations and add to QT effects. The oral formulation is the main concern, as the label warns about CYP3A substrates that prolong the QT interval.
What this interaction means in plain words
Lefamulin and Ranolazine 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; Ranolazine belongs to Cardiovascular.
Why it happens
CYP3A4 inhibition by lefamulin plus additive QT prolongation.
What to do
Avoid combining with oral lefamulin, and use an alternative antibiotic if possible. If used, 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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine 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 Ranolazine?
MediHelp rates the interaction as major. Lefamulin and Ranolazine 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 and prolongs the QT interval, so it can raise ranolazine concentrations and add to QT effects. The oral formulation is the main concern, as the label warns about CYP3A substrates that prolong the QT interval.
How serious is the interaction between Lefamulin and Ranolazine?
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 combining with oral lefamulin, and use an alternative antibiotic if possible. If used, monitor ECG and electrolytes.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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