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Drug Interactions between Coartem and Optison

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

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Interactions between your drugs

Major

perflutren artemether

Applies to: Optison (perflutren) and Coartem (artemether / lumefantrine)

Consumer information for this interaction is not currently available.

CONTRAINDICATED: Perflutren lipid microsphere suspension (Definity) has been reported to cause prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death. In 221 study subjects who received ECG monitoring at various time points from 1 to 72 hours following administration of perflutren lipid microsphere bolus doses of up to 10 microL/kg, QTc prolongations of >30 msec were noted in 64 (29%) subjects. Forty-six out of these 64 subjects were further evaluated, and 18 (39%) were found to have associated cardiac rhythm changes. The effects of concomitant drugs were not studied. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s).

MANAGEMENT: Concomitant use of perflutren lipid microsphere suspension with other agents that can prolong the QT interval may be considered contraindicated in some cases. Please refer to the prescribing information for these drugs for more information. No data are available regarding the effect of perflutren protein-type A microsphere suspension (Optison) on the QT interval of the electrocardiogram.

References

  1. "Product Information. Definity (perflutren)." Lantheus Medical Imaging Inc (2015):
  2. "Product Information. Optison (perflutren)." Mallinckrodt Medical Inc (2015):
Major

perflutren lumefantrine

Applies to: Optison (perflutren) and Coartem (artemether / lumefantrine)

Using lumefantrine together with perflutren lipid microsphere suspension (brand name Definity) is not recommended. Combining these products 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). It is not known if a similar contrast agent, perflutren protein-type A microsphere suspension (brand name Optison), can also cause these effects. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these products. 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

Moderate

lumefantrine food

Applies to: Coartem (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

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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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.