Drug interactions
Primaquine + Sotalol
Severity: Major
Primaquine and Sotalol: major interaction.
Last updated Sources: US FDA label
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
Sotalol is a class III antiarrhythmic with a substantial risk of QT prolongation and torsades de pointes. Adding primaquine may increase this risk.
What this interaction means in plain words
Primaquine and Sotalol 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.
Primaquine belongs to Anti Parasitic; Sotalol belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic QT prolongation through potassium channel blockade.
What to do
Avoid the combination and choose another antimalarial if possible. If it cannot be avoided, monitor the ECG and electrolytes and reduce the sotalol dose if the QTc increases markedly.
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
Other interactions of Primaquine
- Pimozide + Primaquine Contraindicated
- Amiodarone + Primaquine Major
- Amisulpride + Primaquine Major
- Anagrelide + Primaquine Major
- Arsenic trioxide + Primaquine Major
- Asenapine + Primaquine Major
Other interactions of Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
Frequently asked questions
Can I take Primaquine with Sotalol?
MediHelp rates the interaction as major. Primaquine and Sotalol 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. Sotalol is a class III antiarrhythmic with a substantial risk of QT prolongation and torsades de pointes. Adding primaquine may increase this risk.
How serious is the interaction between Primaquine and Sotalol?
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 and choose another antimalarial if possible. If it cannot be avoided, monitor the ECG and electrolytes and reduce the sotalol dose if the QTc increases markedly.
What other medicines interact with Primaquine?
MediHelp also lists interactions of Primaquine with, for example, Pimozide, Amiodarone, Amisulpride. The full list is on the Primaquine page.
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