Drug interactions
Letermovir + Quinine
Severity: Moderate
Letermovir and Quinine: moderate 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
Letermovir is a moderate CYP3A inhibitor and can increase exposure to CYP3A substrates such as quinine. Higher quinine concentrations may cause tinnitus, hypoglycemia and QT prolongation.
What this interaction means in plain words
Letermovir and Quinine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Letermovir belongs to Anti Virals; Quinine belongs to Anti Parasitic.
Why it happens
Letermovir inhibits CYP3A4, decreasing quinine metabolism.
What to do
Monitor for quinine toxicity and ECG changes, and check glucose if symptomatic. Lower the quinine dose if adverse effects occur.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Atorvastatin + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
Frequently asked questions
Can I take Letermovir with Quinine?
MediHelp rates the interaction as moderate. Letermovir and Quinine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Letermovir is a moderate CYP3A inhibitor and can increase exposure to CYP3A substrates such as quinine. Higher quinine concentrations may cause tinnitus, hypoglycemia and QT prolongation.
How serious is the interaction between Letermovir and Quinine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for quinine toxicity and ECG changes, and check glucose if symptomatic. Lower the quinine dose if adverse effects occur.
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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