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Drug Interactions between artemether / lumefantrine and halofantrine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

halofantrine artemether

Applies to: halofantrine and artemether / lumefantrine

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Halofantrine and artemether-lumefantrine may have additive prolonging effects on the QT interval. Theoretically, coadministration may increase the risk of ventricular arrhythmias including ventricular tachycardia and torsade de pointes, which can lead to cardiac arrest and sudden death in some cases. In vitro studies also indicate that lumefantrine metabolism is inhibited by halofantrine.

MANAGEMENT: Halofantrine and lumefantrine should not be administered within one month of each other due to their long elimination half-lives (6 to 10 days for halofantrine and 3 to 6 days for lumefantrine).

References

  1. "Product Information. Halfan (halofantrine)." GlaxoSmithKline (2003):
  2. "Product Information. Coartem (artemether-lumefantrine)." Novartis Pharmaceuticals (2009):
Major

halofantrine lumefantrine

Applies to: halofantrine and artemether / lumefantrine

Using halofantrine together with lumefantrine, or within 30 days of each other, is not recommended. Combining these medications can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Generally, it is best to wait approximately one month after finishing treatment with one before beginning the other. Talk to your doctor if you have any questions or concerns. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Major

halofantrine food

Applies to: halofantrine

You may experience reduced absorption of halofantrine in the presence of food. Halofantrine should be taken on an empty stomach at least 1 hour before or 2 hours after food. This will make it easier for your body to absorb the medication. Also, while taking halofantrine, you should avoid grapefruits and grapefruit juice. Grapefruit can raise the levels of halofantrine in your body and lead to increased adverse effects. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

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Moderate

lumefantrine food

Applies to: artemether / lumefantrine

Each dose of lumefantrine should be taken with food such as milk, infant formula, pudding, porridge, or broth. Food helps the medication get absorbed into the bloodstream, so the medication may not work as well when taken on an empty stomach. If unable to be swallowed whole, lumefantrine tablets may be crushed and mixed with one to two teaspoons of water in a clean container and consumed immediately after mixing. The container should then be rinsed with more water and the contents consumed. This should be followed by eating as soon as possible. Avoid drinking grapefruit juice during treatment with lumefantrine. Grapefruit juice can cause too much of the medication to be in the blood. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Antimalarials

Therapeutic duplication

The recommended maximum number of medicines in the 'antimalarials' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antimalarials' category:

  • artemether/lumefantrine
  • halofantrine

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer