Drug interactions
Lumefantrine + Paroxetine
Severity: Major
Lumefantrine and Paroxetine: major interaction.
Last updated Sources: UK SmPC
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
Lumefantrine inhibits CYP2D6 and can raise paroxetine levels, and both drugs can prolong the QTc interval. The combination increases the risk of QT-related arrhythmia.
What this interaction means in plain words
Lumefantrine and Paroxetine 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
CYP2D6 inhibition by lumefantrine and additive QTc prolongation.
What to do
Obtain a baseline ECG and correct potassium and magnesium abnormalities. Avoid the combination in patients with other QT risk factors or consider an alternative antimalarial.
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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References
- Paroxetine 10 mg Tablets - SmPC sections 4.3/4.5 (class statement: drugs which prolong the QTc interval; "The risk of QTc prolongation and/or ventricular arrhythmias (e.g. TdP) may be increased with concomitant use of other drugs which prolong the QTc interval (e.g.") — electronic medicines compendium (UK SmPC)
Other interactions of Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Lumefantrine with Paroxetine?
MediHelp rates the interaction as major. Lumefantrine and Paroxetine 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. Lumefantrine inhibits CYP2D6 and can raise paroxetine levels, and both drugs can prolong the QTc interval. The combination increases the risk of QT-related arrhythmia.
How serious is the interaction between Lumefantrine and Paroxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and correct potassium and magnesium abnormalities. Avoid the combination in patients with other QT risk factors or consider an alternative antimalarial.
What other medicines interact with Paroxetine?
MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Paroxetine page.
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