Drug interactions
Lumefantrine + Nortriptyline
Severity: Major
Lumefantrine and Nortriptyline: 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
Both drugs can prolong the QT interval, and lumefantrine may also inhibit CYP2D6 and raise nortriptyline exposure. The combined effect increases the risk of torsades de pointes.
What this interaction means in plain words
Lumefantrine and Nortriptyline 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
Additive QT prolongation plus CYP2D6 inhibition by lumefantrine.
What to do
Avoid where possible, using a different antimalarial or antidepressant. If unavoidable, obtain an ECG, correct electrolytes and monitor for tricyclic toxicity.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Frequently asked questions
Can I take Lumefantrine with Nortriptyline?
MediHelp rates the interaction as major. Lumefantrine and Nortriptyline 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. Both drugs can prolong the QT interval, and lumefantrine may also inhibit CYP2D6 and raise nortriptyline exposure. The combined effect increases the risk of torsades de pointes.
How serious is the interaction between Lumefantrine and Nortriptyline?
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 where possible, using a different antimalarial or antidepressant. If unavoidable, obtain an ECG, correct electrolytes and monitor for tricyclic toxicity.
What other medicines interact with Nortriptyline?
MediHelp also lists interactions of Nortriptyline with, for example, Disopyramide, Dofetilide, Dronedarone. The full list is on the Nortriptyline page.
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