artemether/lumefantrine (Rx)

Brand and Other Names:Coartem
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

artemether/lumefantrine

tablet

  • 20mg/120mg

Malaria

35 kg or greater: Administer 24 tablets over 3 days; use a 3-day treatment schedule with total of 6 doses

Day 1: 4 tablets initially and 4 tablets again after 8 hours

Days 2 & 3: 4 tablets BID (morning & evening)

Administration

Take with food

If patient vomits out dose within 1-2 hours, give another dose

Dosage Forms & Strengths

artemether/lumefantrine

tablet

  • 20mg/120mg

Malaria

<2 years or <5 kg

  • Safety and efficacy not established

≥2 years

  • 5 to <15 kg: Administer 6 tablets over 3 days; 1 tablet initially and again after 8 hours on first day; follow by 1 tablet BID (morning & evening) for the next 2 days
  • 15 to <25 kg: Administer 12 tablets over 3 days; 2 tablets initially and again after 8 hours on first day; follow by 2 tablets BID (morning & evening) for the next 2 days
  • 25 to <35 kg: Administer 18 tablets over 3 days; 3 tablets initially and again after 8 hr on 1st day; follow by 3 tablets BID (morning & evening) for the next 2 days
  • 35 kg or greater: As in adults; administer 24 tablets over 3 days; 4 tablets initially and again after 8 hr on 1st day; follow by 4 tablets BID (morning & evening) for the next 2 days

Administration

Take with food

May crush tablets & mix with small amount of water; follow dose with food or drink

If patient vomits out dose within 1-2 hours, give another dose

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Interactions

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            Contraindicated (31)

            • arsenic trioxide

              arsenic trioxide and artemether/lumefantrine both increase QTc interval. Contraindicated.

            • bosentan

              bosentan will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • carbamazepine

              carbamazepine will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • chloroquine

              artemether/lumefantrine increases toxicity of chloroquine by QTc interval. Contraindicated.

            • clomipramine

              artemether/lumefantrine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.

            • dexamethasone

              dexamethasone will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • disopyramide

              disopyramide and artemether/lumefantrine both increase QTc interval. Contraindicated.

            • enzalutamide

              enzalutamide will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • eslicarbazepine acetate

              eslicarbazepine acetate will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • etravirine

              etravirine will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • fluoxetine

              artemether/lumefantrine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.

            • fosphenytoin

              fosphenytoin will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • goserelin

              goserelin increases toxicity of artemether/lumefantrine by QTc interval. Contraindicated.

            • ibutilide

              ibutilide and artemether/lumefantrine both increase QTc interval. Contraindicated.

            • indapamide

              indapamide and artemether/lumefantrine both increase QTc interval. Contraindicated.

            • leuprolide

              leuprolide increases toxicity of artemether/lumefantrine by QTc interval. Contraindicated.

            • nevirapine

              nevirapine will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • oxcarbazepine

              oxcarbazepine will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • pentamidine

              artemether/lumefantrine and pentamidine both increase QTc interval. Contraindicated.

            • pentobarbital

              pentobarbital will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • phenobarbital

              phenobarbital will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • phenytoin

              phenytoin will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • pimozide

              artemether/lumefantrine and pimozide both increase QTc interval. Contraindicated.

            • primidone

              primidone will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • procainamide

              artemether/lumefantrine and procainamide both increase QTc interval. Contraindicated.

            • quinidine

              quinidine and artemether/lumefantrine both increase QTc interval. Contraindicated.

            • rifabutin

              rifabutin will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • rifampin

              rifampin will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • rifapentine

              rifapentine will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

            • sotalol

              artemether/lumefantrine and sotalol both increase QTc interval. Contraindicated.

            • St John's Wort

              St John's Wort will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration can result in decreased concentrations and loss of antimalarial efficacy

            Serious - Use Alternative (123)

            • abametapir

              abametapir will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

            • alfuzosin

              alfuzosin and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • amiodarone

              amiodarone and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • amitriptyline

              amitriptyline and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • amoxapine

              amoxapine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • anagrelide

              artemether/lumefantrine and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.

            • apalutamide

              apalutamide will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

            • apomorphine

              apomorphine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • aripiprazole

              aripiprazole and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • atomoxetine

              atomoxetine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine

              artemether/lumefantrine and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.

            • carvedilol

              artemether/lumefantrine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • ceritinib

              ceritinib and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • chlorpromazine

              chlorpromazine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • cimetidine

              cimetidine will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • clarithromycin

              clarithromycin will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              clarithromycin and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • clomipramine

              clomipramine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • clozapine

              clozapine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • dabrafenib

              dabrafenib will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • dapsone topical

              artemether/lumefantrine, dapsone topical. unspecified interaction mechanism. Avoid or Use Alternate Drug. Avoid coadministration of dapsone topical with oral dapsone or antimalarial medications because of the potential for hemolytic reactions.

            • deflazacort

              artemether/lumefantrine will decrease the level or effect of deflazacort by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of deflazacort with moderate or strong CYP3A4 inducers.

            • degarelix

              degarelix and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • desflurane

              desflurane and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • desipramine

              artemether/lumefantrine will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

              desipramine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • deutetrabenazine

              deutetrabenazine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • dihydroergotamine

              artemether/lumefantrine will decrease the level or effect of dihydroergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • dihydroergotamine intranasal

              artemether/lumefantrine will decrease the level or effect of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • dofetilide

              dofetilide and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • donepezil

              donepezil and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • doxepin

              artemether/lumefantrine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

              doxepin and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • dronedarone

              artemether/lumefantrine will decrease the level or effect of dronedarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

              dronedarone and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • droperidol

              droperidol and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • duloxetine

              artemether/lumefantrine will increase the level or effect of duloxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • efavirenz

              efavirenz will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacy

              efavirenz and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • eliglustat

              artemether/lumefantrine and eliglustat both increase QTc interval. Avoid or Use Alternate Drug.

            • epinephrine

              epinephrine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • epinephrine racemic

              epinephrine racemic and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • ergotamine

              artemether/lumefantrine will decrease the level or effect of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • eribulin

              eribulin and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. Potential for enhanced QTc-prolonging effects; if concurrent use is necessary then ECG monitoring is recommended.

            • erythromycin base

              artemether/lumefantrine will decrease the level or effect of erythromycin base by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

              erythromycin base will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              erythromycin base and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin ethylsuccinate

              artemether/lumefantrine will decrease the level or effect of erythromycin ethylsuccinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

              erythromycin ethylsuccinate will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              erythromycin ethylsuccinate and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin lactobionate

              artemether/lumefantrine will decrease the level or effect of erythromycin lactobionate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

              erythromycin lactobionate will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              erythromycin lactobionate and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin stearate

              artemether/lumefantrine will decrease the level or effect of erythromycin stearate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

              erythromycin stearate will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              erythromycin stearate and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • escitalopram

              escitalopram increases toxicity of artemether/lumefantrine by QTc interval. Avoid or Use Alternate Drug.

            • everolimus

              artemether/lumefantrine will decrease the level or effect of everolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • fexinidazole

              fexinidazole and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.

              fexinidazole will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

            • flecainide

              artemether/lumefantrine will increase the level or effect of flecainide by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • fluconazole

              fluconazole and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • fluphenazine

              fluphenazine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • formoterol

              formoterol and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • gilteritinib

              artemether/lumefantrine and gilteritinib both increase QTc interval. Avoid or Use Alternate Drug.

            • glasdegib

              artemether/lumefantrine and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

            • granisetron

              artemether/lumefantrine and granisetron both increase QTc interval. Avoid or Use Alternate Drug.

            • haloperidol

              artemether/lumefantrine will increase the level or effect of haloperidol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

              haloperidol and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • histrelin

              histrelin increases toxicity of artemether/lumefantrine by QTc interval. Avoid or Use Alternate Drug.

            • hydroxychloroquine sulfate

              hydroxychloroquine sulfate and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • hydroxyzine

              artemether/lumefantrine and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.

            • idelalisib

              idelalisib will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

            • iloperidone

              artemether/lumefantrine will increase the level or effect of iloperidone by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • imipramine

              artemether/lumefantrine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

              imipramine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • inotuzumab

              inotuzumab and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.

            • isoflurane

              artemether/lumefantrine and isoflurane both increase QTc interval. Avoid or Use Alternate Drug.

            • itraconazole

              artemether/lumefantrine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • ivosidenib

              ivosidenib and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.

            • ketoconazole

              ketoconazole will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              ketoconazole and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • lithium

              artemether/lumefantrine and lithium both increase QTc interval. Avoid or Use Alternate Drug.

            • lofepramine

              artemether/lumefantrine will increase the level or effect of lofepramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

              lofepramine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • loperamide

              artemether/lumefantrine and loperamide both increase QTc interval. Avoid or Use Alternate Drug.

            • lovastatin

              artemether/lumefantrine will decrease the level or effect of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • macimorelin

              macimorelin and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.

            • maprotiline

              maprotiline and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • methamphetamine

              artemether/lumefantrine will increase the level or effect of methamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • metoprolol

              artemether/lumefantrine will increase the level or effect of metoprolol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • mexiletine

              artemether/lumefantrine will increase the level or effect of mexiletine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • midostaurin

              artemether/lumefantrine and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.

            • mifepristone

              mifepristone will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • mirtazapine

              artemether/lumefantrine and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.

            • mobocertinib

              mobocertinib and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.

            • morphine

              artemether/lumefantrine will increase the level or effect of morphine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • moxifloxacin

              artemether/lumefantrine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • nebivolol

              artemether/lumefantrine will increase the level or effect of nebivolol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • nefazodone

              nefazodone will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • nilotinib

              artemether/lumefantrine and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

            • nortriptyline

              artemether/lumefantrine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

              nortriptyline and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • octreotide

              artemether/lumefantrine and octreotide both increase QTc interval. Avoid or Use Alternate Drug.

            • octreotide (Antidote)

              artemether/lumefantrine and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.

            • ondansetron

              artemether/lumefantrine and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

            • oxaliplatin

              artemether/lumefantrine and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.

            • oxycodone

              artemether/lumefantrine will increase the level or effect of oxycodone by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • oxymorphone

              artemether/lumefantrine will increase the level or effect of oxymorphone by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • ozanimod

              artemether/lumefantrine and ozanimod both increase QTc interval. Avoid or Use Alternate Drug.

            • panobinostat

              artemether/lumefantrine and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

            • perphenazine

              perphenazine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • pimavanserin

              pimavanserin and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.

            • ponesimod

              artemether/lumefantrine and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.

            • prochlorperazine

              prochlorperazine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • promazine

              promazine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • promethazine

              promethazine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • propafenone

              artemether/lumefantrine will increase the level or effect of propafenone by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • propranolol

              artemether/lumefantrine will increase the level or effect of propranolol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • protriptyline

              protriptyline and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • ranolazine

              artemether/lumefantrine will decrease the level or effect of ranolazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • ribociclib

              ribociclib and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

              ribociclib will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • romidepsin

              artemether/lumefantrine and romidepsin both increase QTc interval. Avoid or Use Alternate Drug.

            • saquinavir

              saquinavir increases levels of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Potential for increased toxicity. Increased risk of QT prolongation and cardiac arrhythmias.

            • selpercatinib

              artemether/lumefantrine and selpercatinib both increase QTc interval. Avoid or Use Alternate Drug.

            • sevoflurane

              artemether/lumefantrine and sevoflurane both increase QTc interval. Avoid or Use Alternate Drug.

            • silodosin

              artemether/lumefantrine will decrease the level or effect of silodosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • simvastatin

              artemether/lumefantrine will decrease the level or effect of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • siponimod

              artemether/lumefantrine and siponimod both increase QTc interval. Avoid or Use Alternate Drug.

            • sirolimus

              artemether/lumefantrine will decrease the level or effect of sirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • thioridazine

              artemether/lumefantrine will increase the level or effect of thioridazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

              thioridazine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • timolol

              artemether/lumefantrine will increase the level or effect of timolol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

            • tolvaptan

              artemether/lumefantrine will decrease the level or effect of tolvaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • trazodone

              trazodone and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

              artemether/lumefantrine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

            • trifluoperazine

              trifluoperazine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • trimipramine

              trimipramine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • triptorelin

              triptorelin increases toxicity of artemether/lumefantrine by QTc interval. Avoid or Use Alternate Drug.

            • umeclidinium bromide/vilanterol inhaled

              artemether/lumefantrine increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

            • vandetanib

              artemether/lumefantrine, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.

            • vemurafenib

              vemurafenib and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.

            • vilanterol/fluticasone furoate inhaled

              artemether/lumefantrine increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

            • ziprasidone

              artemether/lumefantrine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.

            Monitor Closely (180)

            • albuterol

              albuterol and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.

            • alitretinoin

              artemether/lumefantrine will decrease the level or effect of alitretinoin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • almotriptan

              artemether/lumefantrine will decrease the level or effect of almotriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • alprazolam

              artemether/lumefantrine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • amiodarone

              artemether/lumefantrine increases effects of amiodarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Additive QTc prolongation effects. Concomitant use of lumefantrine with other drugs that prolong the QT interval such as Class III antiarrhythmics should be avoided.

            • amobarbital

              amobarbital will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • aprepitant

              aprepitant will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • arformoterol

              arformoterol and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.

            • aripiprazole

              artemether/lumefantrine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              artemether/lumefantrine will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • armodafinil

              armodafinil will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • atazanavir

              atazanavir will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • atomoxetine

              artemether/lumefantrine will increase the level or effect of atomoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • atorvastatin

              artemether/lumefantrine will decrease the level or effect of atorvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • avanafil

              artemether/lumefantrine will decrease the level or effect of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. For patients with ED, monitor response carefully because of potential for decreased effectiveness.

            • azithromycin

              azithromycin and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.

            • bazedoxifene/conjugated estrogens

              artemether/lumefantrine will decrease the level or effect of bazedoxifene/conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • bedaquiline

              artemether/lumefantrine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

            • benzhydrocodone/acetaminophen

              artemether/lumefantrine will increase the level or effect of benzhydrocodone/acetaminophen by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Hydromorphone (<3% of the circulating parent hydrocodone [benzhydrocodone is prodrug of hydrocodone]) is mainly formed by CYP2D6 mediated O-demethylation of hydrocodone. Hydromorphone may contribute to the total analgesic effect of hydrocodone.

            • budesonide

              artemether/lumefantrine will decrease the level or effect of budesonide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              budesonide will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • bupivacaine implant

              artemether/lumefantrine, bupivacaine implant. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia.

            • buspirone

              artemether/lumefantrine will decrease the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • butabarbital

              butabarbital will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • butalbital

              butalbital will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • carbamazepine

              artemether/lumefantrine will decrease the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • chloramphenicol

              chloramphenicol will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • chlorpromazine

              artemether/lumefantrine will increase the level or effect of chlorpromazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • cilostazol

              artemether/lumefantrine will decrease the level or effect of cilostazol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • cinacalcet

              artemether/lumefantrine will decrease the level or effect of cinacalcet by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ciprofloxacin

              ciprofloxacin and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor. Ciprofloxacin elicits minimal effects on QT interval. Caution if used in combination with other drugs known to affect QT interval or in patients with other risk factors.

            • citalopram

              artemether/lumefantrine and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

            • clobetasone

              artemether/lumefantrine will decrease the level or effect of clobetasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • clopidogrel

              artemether/lumefantrine will increase the level or effect of clopidogrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CYP3A4 inducers may increase the metabolism of clopidogrel to its active metabolite. Monitor patients for potential increase in antiplatelet effects when CYP3A4 inducers are used in combination with clopidogrel

            • clozapine

              artemether/lumefantrine will decrease the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • cobicistat

              cobicistat will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • codeine

              artemether/lumefantrine will increase the level or effect of codeine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • colchicine

              artemether/lumefantrine will decrease the level or effect of colchicine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • conivaptan

              conivaptan will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • conjugated estrogens

              artemether/lumefantrine will decrease the level or effect of conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • conjugated estrogens, vaginal

              artemether/lumefantrine will decrease the level or effect of conjugated estrogens, vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • cortisone

              artemether/lumefantrine will decrease the level or effect of cortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              cortisone will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • crizotinib

              crizotinib and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

            • cyclosporine

              artemether/lumefantrine will decrease the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              cyclosporine will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • darifenacin

              artemether/lumefantrine will decrease the level or effect of darifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              darifenacin will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • darunavir

              darunavir will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased lumefantrine exposure may prolong QT interval

            • dasatinib

              dasatinib will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              dasatinib and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.

            • dexamethasone

              artemether/lumefantrine will decrease the level or effect of dexamethasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • dexfenfluramine

              artemether/lumefantrine will increase the level or effect of dexfenfluramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • dextroamphetamine

              artemether/lumefantrine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • dextromethorphan

              artemether/lumefantrine will increase the level or effect of dextromethorphan by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • DHEA, herbal

              DHEA, herbal will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • diazepam

              artemether/lumefantrine will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • diltiazem

              artemether/lumefantrine will decrease the level or effect of diltiazem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              diltiazem will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with artemether/lumefantrine may increase artemether/lumefantrine levels and toxicities (eg, cardiac arrhythmias).

            • disopyramide

              artemether/lumefantrine will decrease the level or effect of disopyramide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Additive QTc prolongation effects. Concomitant use of artemether; lumefantrine with other drugs that prolong the QT interval such as Class IA antiarrhythmics should be avoided.

            • dolasetron

              dolasetron and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.

            • donepezil

              artemether/lumefantrine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • dronedarone

              dronedarone will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • eletriptan

              artemether/lumefantrine will decrease the level or effect of eletriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • encainide

              artemether/lumefantrine will increase the level or effect of encainide by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • erlotinib

              artemether/lumefantrine will decrease the level or effect of erlotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • estradiol

              artemether/lumefantrine will decrease the level or effect of estradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • estrogens conjugated synthetic

              artemether/lumefantrine will decrease the level or effect of estrogens conjugated synthetic by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • estrogens esterified

              artemether/lumefantrine will decrease the level or effect of estrogens esterified by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • estropipate

              artemether/lumefantrine will decrease the level or effect of estropipate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ethinylestradiol

              artemether/lumefantrine will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • etonogestrel

              artemether/lumefantrine will decrease the level or effect of etonogestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • exemestane

              artemether/lumefantrine will decrease the level or effect of exemestane by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. For patients receiving exemestane with a potent CYP3A4 inducer the recommended dose of exemestane is 50 mg daily after a meal.

            • ezogabine

              ezogabine, artemether/lumefantrine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

            • felodipine

              artemether/lumefantrine will decrease the level or effect of felodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • fesoterodine

              artemether/lumefantrine will increase the level or effect of fesoterodine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              artemether/lumefantrine will decrease the level or effect of fesoterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • flecainide

              flecainide and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.

            • fluconazole

              fluconazole will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • fludrocortisone

              artemether/lumefantrine will decrease the level or effect of fludrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              fludrocortisone will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • fluoxetine

              fluoxetine and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.

            • fluphenazine

              artemether/lumefantrine will increase the level or effect of fluphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • fosamprenavir

              fosamprenavir will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • foscarnet

              foscarnet and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.

            • fostemsavir

              artemether/lumefantrine and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

            • galantamine

              artemether/lumefantrine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • gemtuzumab

              artemether/lumefantrine and gemtuzumab both increase QTc interval. Use Caution/Monitor.

            • grapefruit

              grapefruit will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • griseofulvin

              griseofulvin will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • guanfacine

              artemether/lumefantrine will decrease the level or effect of guanfacine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • hydrocodone

              artemether/lumefantrine will increase the level or effect of hydrocodone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Hydromorphone (<3% of the circulating parent hydrocodone) is mainly formed by CYP2D6 mediated O-demethylation of hydrocodone. Hydromorphone may contribute to the total analgesic effect of hydrocodone.

            • hydrocortisone

              artemether/lumefantrine will decrease the level or effect of hydrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              hydrocortisone will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • hydromorphone

              artemether/lumefantrine will increase the level or effect of hydromorphone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • hydroxyprogesterone caproate

              artemether/lumefantrine will decrease the level or effect of hydroxyprogesterone caproate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • iloperidone

              artemether/lumefantrine will decrease the level or effect of iloperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              iloperidone and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.

            • indacaterol, inhaled

              indacaterol, inhaled, artemether/lumefantrine. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

            • indinavir

              artemether/lumefantrine will decrease the level or effect of indinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              indinavir will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • isoniazid

              isoniazid will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • istradefylline

              istradefylline will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

            • itraconazole

              artemether/lumefantrine will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              itraconazole and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.

            • ivosidenib

              ivosidenib will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ixabepilone

              artemether/lumefantrine will decrease the level or effect of ixabepilone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • lapatinib

              lapatinib will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              lapatinib and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.

            • lenvatinib

              artemether/lumefantrine and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

            • levalbuterol

              artemether/lumefantrine and levalbuterol both increase QTc interval. Use Caution/Monitor.

            • levofloxacin

              levofloxacin and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.

            • lopinavir

              artemether/lumefantrine will decrease the level or effect of lopinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              lopinavir, artemether/lumefantrine. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lopinavir may increase or decrease levels of lumefantrine.

            • loratadine

              artemether/lumefantrine will increase the level or effect of loratadine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              artemether/lumefantrine will decrease the level or effect of loratadine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • lorlatinib

              lorlatinib will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • maraviroc

              artemether/lumefantrine will decrease the level or effect of maraviroc by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • marijuana

              marijuana will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • mefloquine

              mefloquine decreases levels of artemether/lumefantrine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Mefloquine decreases bile production; take Coartem (lumefantrine) during food consumption.

            • mestranol

              artemether/lumefantrine will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • methadone

              artemether/lumefantrine will decrease the level or effect of methadone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              artemether/lumefantrine and methadone both increase QTc interval. Modify Therapy/Monitor Closely.

            • methylprednisolone

              artemether/lumefantrine will decrease the level or effect of methylprednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              methylprednisolone will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • metronidazole

              metronidazole will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • miconazole vaginal

              miconazole vaginal will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • midazolam

              artemether/lumefantrine will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • mifepristone

              mifepristone, artemether/lumefantrine. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

            • mitotane

              mitotane decreases levels of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

            • modafinil

              modafinil will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nelfinavir

              artemether/lumefantrine will decrease the level or effect of nelfinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              nelfinavir will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nicardipine

              artemether/lumefantrine will decrease the level or effect of nicardipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nifedipine

              nifedipine will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nilotinib

              nilotinib will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nilutamide

              nilutamide will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nisoldipine

              artemether/lumefantrine will decrease the level or effect of nisoldipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ofloxacin

              artemether/lumefantrine and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • olodaterol inhaled

              artemether/lumefantrine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

            • osilodrostat

              osilodrostat and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.

            • osimertinib

              osimertinib and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

            • oxaliplatin

              oxaliplatin will increase the level or effect of artemether/lumefantrine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

            • ozanimod

              ozanimod and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

            • paliperidone

              artemether/lumefantrine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.

            • paroxetine

              artemether/lumefantrine will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              artemether/lumefantrine and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.

            • pasireotide

              artemether/lumefantrine and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

            • pazopanib

              artemether/lumefantrine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              artemether/lumefantrine and pazopanib both increase QTc interval. Use Caution/Monitor.

            • perhexiline

              artemether/lumefantrine will increase the level or effect of perhexiline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • perphenazine

              artemether/lumefantrine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • posaconazole

              artemether/lumefantrine and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.

              posaconazole will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • prednisolone

              artemether/lumefantrine will decrease the level or effect of prednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • prednisone

              artemether/lumefantrine will decrease the level or effect of prednisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              prednisone will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • primaquine

              artemether/lumefantrine and primaquine both increase QTc interval. Use Caution/Monitor.

            • prochlorperazine

              artemether/lumefantrine will increase the level or effect of prochlorperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • promazine

              artemether/lumefantrine will increase the level or effect of promazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • promethazine

              artemether/lumefantrine will increase the level or effect of promethazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • quetiapine

              artemether/lumefantrine will decrease the level or effect of quetiapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              quetiapine, artemether/lumefantrine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.

            • quinidine

              artemether/lumefantrine will decrease the level or effect of quinidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • quinine

              artemether/lumefantrine and quinine both increase QTc interval. Use Caution/Monitor.

            • quinupristin/dalfopristin

              quinupristin/dalfopristin will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ranolazine

              artemether/lumefantrine and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.

            • repaglinide

              artemether/lumefantrine will decrease the level or effect of repaglinide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rilpivirine

              rilpivirine increases toxicity of artemether/lumefantrine by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.

            • risperidone

              artemether/lumefantrine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              artemether/lumefantrine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.

            • ritonavir

              ritonavir, artemether/lumefantrine. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Ritonavir may increase or decrease levels of lumefantrine.

            • romidepsin

              artemether/lumefantrine will decrease the level or effect of romidepsin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rufinamide

              rufinamide will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • saquinavir

              artemether/lumefantrine will decrease the level or effect of saquinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • secobarbital

              secobarbital will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • selpercatinib

              selpercatinib increases toxicity of artemether/lumefantrine by QTc interval. Use Caution/Monitor.

            • sildenafil

              artemether/lumefantrine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • solifenacin

              artemether/lumefantrine will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • sorafenib

              sorafenib and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.

            • sulfamethoxazole

              sulfamethoxazole and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.

            • sunitinib

              artemether/lumefantrine will decrease the level or effect of sunitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tacrolimus

              artemether/lumefantrine will decrease the level or effect of tacrolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tadalafil

              artemether/lumefantrine will decrease the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • telavancin

              artemether/lumefantrine and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.

            • temsirolimus

              artemether/lumefantrine will decrease the level or effect of temsirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • theophylline

              artemether/lumefantrine will decrease the level or effect of theophylline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tipranavir

              artemether/lumefantrine will decrease the level or effect of tipranavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              tipranavir will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tolterodine

              artemether/lumefantrine will increase the level or effect of tolterodine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              artemether/lumefantrine will decrease the level or effect of tolterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • topiramate

              topiramate will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tramadol

              artemether/lumefantrine will increase the level or effect of tramadol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • trazodone

              artemether/lumefantrine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • triamcinolone acetonide injectable suspension

              artemether/lumefantrine will decrease the level or effect of triamcinolone acetonide injectable suspension by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • triazolam

              artemether/lumefantrine will decrease the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • triclabendazole

              triclabendazole and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.

            • trifluoperazine

              artemether/lumefantrine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • trimethoprim

              artemether/lumefantrine and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.

            • tropisetron

              artemether/lumefantrine will increase the level or effect of tropisetron by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              artemether/lumefantrine and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.

            • vardenafil

              artemether/lumefantrine will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • venlafaxine

              artemether/lumefantrine and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.

            • verapamil

              verapamil will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • voclosporin

              voclosporin, artemether/lumefantrine. Either increases effects of the other by QTc interval. Use Caution/Monitor.

            • voriconazole

              artemether/lumefantrine and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.

              voriconazole will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • warfarin

              artemether/lumefantrine will decrease the level or effect of warfarin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • zafirlukast

              zafirlukast will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            Minor (56)

            • alfentanil

              artemether/lumefantrine will decrease the level or effect of alfentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • alfuzosin

              artemether/lumefantrine will decrease the level or effect of alfuzosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • aliskiren

              artemether/lumefantrine will decrease the level or effect of aliskiren by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • alosetron

              artemether/lumefantrine will decrease the level or effect of alosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • amitriptyline

              artemether/lumefantrine will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • amlodipine

              artemether/lumefantrine will decrease the level or effect of amlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • armodafinil

              artemether/lumefantrine will decrease the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • atazanavir

              artemether/lumefantrine will decrease the level or effect of atazanavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • bexarotene

              artemether/lumefantrine will decrease the level or effect of bexarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • bosentan

              artemether/lumefantrine will decrease the level or effect of bosentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • cevimeline

              artemether/lumefantrine will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • chloroquine

              chloroquine increases toxicity of artemether/lumefantrine by QTc interval. Minor/Significance Unknown.

            • clarithromycin

              artemether/lumefantrine will decrease the level or effect of clarithromycin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • clomipramine

              artemether/lumefantrine will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • dapsone

              artemether/lumefantrine will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • desipramine

              artemether/lumefantrine will decrease the level or effect of desipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • docetaxel

              artemether/lumefantrine will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • donepezil

              artemether/lumefantrine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • doxorubicin

              artemether/lumefantrine will decrease the level or effect of doxorubicin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • doxorubicin liposomal

              artemether/lumefantrine will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • dutasteride

              artemether/lumefantrine will decrease the level or effect of dutasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • efavirenz

              artemether/lumefantrine will decrease the level or effect of efavirenz by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • eplerenone

              artemether/lumefantrine will decrease the level or effect of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • etoposide

              artemether/lumefantrine will decrease the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • eucalyptus

              artemether/lumefantrine will decrease the level or effect of eucalyptus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • finasteride

              artemether/lumefantrine will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • food

              food increases levels of artemether/lumefantrine by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Desirable interaction; coadministration with food recommended.

            • galantamine

              artemether/lumefantrine will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • imatinib

              artemether/lumefantrine will decrease the level or effect of imatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • imipramine

              artemether/lumefantrine will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • isradipine

              artemether/lumefantrine will decrease the level or effect of isradipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • ketoconazole

              artemether/lumefantrine will decrease the level or effect of ketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • montelukast

              artemether/lumefantrine will decrease the level or effect of montelukast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • nifedipine

              artemether/lumefantrine will decrease the level or effect of nifedipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • nimodipine

              artemether/lumefantrine will decrease the level or effect of nimodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • nitrendipine

              artemether/lumefantrine will decrease the level or effect of nitrendipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • oxybutynin

              artemether/lumefantrine will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • paclitaxel

              artemether/lumefantrine will decrease the level or effect of paclitaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • paclitaxel protein bound

              artemether/lumefantrine will decrease the level or effect of paclitaxel protein bound by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • parecoxib

              artemether/lumefantrine will decrease the level or effect of parecoxib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • pimozide

              artemether/lumefantrine will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • pioglitazone

              artemether/lumefantrine will decrease the level or effect of pioglitazone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • propafenone

              artemether/lumefantrine will decrease the level or effect of propafenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • quinine

              artemether/lumefantrine will decrease the level or effect of quinine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • ramelteon

              artemether/lumefantrine will decrease the level or effect of ramelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • saxagliptin

              artemether/lumefantrine will decrease the level or effect of saxagliptin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • sufentanil

              artemether/lumefantrine will decrease the level or effect of sufentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • tamoxifen

              artemether/lumefantrine will decrease the level or effect of tamoxifen by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • vinblastine

              artemether/lumefantrine will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • vincristine

              artemether/lumefantrine will decrease the level or effect of vincristine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • vincristine liposomal

              artemether/lumefantrine will decrease the level or effect of vincristine liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • vinorelbine

              artemether/lumefantrine will decrease the level or effect of vinorelbine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • zaleplon

              artemether/lumefantrine will decrease the level or effect of zaleplon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • ziprasidone

              artemether/lumefantrine will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • zolpidem

              artemether/lumefantrine will decrease the level or effect of zolpidem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • zonisamide

              artemether/lumefantrine will decrease the level or effect of zonisamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

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            Adverse Effects

            >10%

            Abdominal pain (17%)

            Anorexia (40%)

            Arthralgia (34%)

            Asthenia (38%)

            Chills (23%)

            Dizziness (39%)

            Fatigue (17%)

            Headache (56%)

            Myalgia (32%)

            Nausea (26%)

            Palpitations (18%)

            Pyrexia (25%)

            Sleep disorder (22%)

            Vomiting (17%)

            1-10%

            Anemia (4%)

            Cough (6%)

            Diarrhea (7%)

            Hepatomegaly (9%)

            Malaise (3%)

            Nasopharyngitis (3%)

            Pruritus (4%)

            Rash (3%)

            Splenomegaly (9%)

            Vertigo (3%)

            Postmarketing Reports

            Anaphylaxis

            Urticaria

            Angioedema

            Skin reactions (bullous eruption)

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            Warnings

            Contraindications

            Hypersensitivity

            Coadministration with strong CYP3A4 inducers (eg, rifampin, carbamazepine, phenytoin, St. John’s wort) can result in decreased artemether and/or lumefantrine serum concentrations and loss of antimalarial efficacy

            Cautions

            Not approved for severe/complicated P. falciparum infections

            Not approved for prevention

            Concurrent CYP3A4 or CYP2D6 inhibitors / inducers

            May render hormonal contraceptives ineffective

            If patient vomits out drug repeatedly, use alternative treatment

            Avoid with conditions that prolong QT

            • Long QT syndrome, history of symptomatic cardiac disease, clinically relevant bradycardia, or severe cardiac disease
            • Family history of congenital QT prolongation or sudden death
            • Electrolyte imbalance (eg, hypokalemia, hypomagnesemia)
            • Coadministration with other drugs that prolong QT interval (eg, class IA antiarrhythmics [quinidine, procainamide, disopyramide], or class III antiarrhythmics [amiodarone, sotalol] antiarrhythmic agents, antipsychotics [pimozide, ziprasidone], antidepressants; certain antibiotics [macrolide, fluoroquinolones], antiretrovirals [eg, ritonavir], cisapride
            • CYP3A4 and CYP2D6 inhibitors may increase serum levels by inhibiting metabolism, and therefore risk for QT prolongation
            • QT prolongation with other antimalarials; duplicate antimalarials should not be given concomitantly, unless there is no other treatment option, due to limited safety data
            • Not for concomitant administration with halofantrine within one month of each other due to potential additive effects on QT interval
            • Cautiously use quinine and quinidine for malaria following Coartem due to long half-life of Coartem and potential additive QT prolongation
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            Pregnancy & Lactation

            Pregnancy

            Published data from clinical studies and pharmacovigilance data have not established an association between drug use during pregnancy and major birth defects, miscarriage, or adverse maternal or fetal outcomes

            Malaria during and after pregnancy increases risk for adverse pregnancy and neonatal outcomes, including maternal anemia, severe malaria, spontaneous abortion, stillbirths, preterm delivery, low birth weight, intrauterine growth restriction, congenital malaria, and maternal and neonatal mortality

            Contraception

            • May reduce efficacy of hormonal contraceptives; advise patients using hormonal contraceptives to use an alternative non-hormonal contraceptive method or add a barrier method of contraception during treatment

            Infertility

            • In animal fertility studies, administration of repeated doses to female rats (for 2 to 4 weeks) resulted in pregnancy rates that were reduced by one half
            • Male rats dosed for approximately 3 months, abnormal sperm cells, showed decreased sperm motility, and increased testes weight

            Lactation

            There are no data on presence of drug in human milk, effects on breastfed infant or on milk production; drug components are transferred into rat milk; when a drug is transferred into animal milk, it is likely that the drug will also be transferred into human milk

            The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Protein Bound: artemether: 95.4% & lumefantrine: 99.7%

            Peak Plasma Time: artemether 2 hr; lumefantrine 6-8 hr

            Half-Life, Elimination: artemether 2 hr; lumefantrine 3-6 d

            Metabolism: by CYP3A4

            Metabolites: artemether: dihydroartemisinin (DHA) (active); lumefantrine: desbutyl-lumefantrine

            Enzymes Inhibited: lumefantrine: CYP2D6

            Enzymes Induced: artemether: CYP3A4

            Excretion: urine (animal studies)

            Mechanism of Action

            Artemether and active metabolite (DHA): via endoperoxide

            Lumefantrine: unknown; possibly inhibits beta-hematin formation

            Both artemether and lumentantrine inhibit nucleic acid and protein synthesis

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            Patient Handout

            A Patient Handout is not currently available for this monograph.
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            Formulary

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            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.