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Drug Interactions between Coartem and Orlaam

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

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Interactions between your drugs

Major

levomethadyl acetate artemether

Applies to: Orlaam (levomethadyl acetate) and Coartem (artemether / lumefantrine)

Consumer information for this interaction is not currently available.

CONTRAINDICATED: Levomethadyl acetate may cause dose-related 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. High dosages of levomethadyl acetate alone have been associated with QT interval prolongation and torsade de pointes. 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). The extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s). In addition, central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking levomethadyl acetate with certain other drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: Coadministration of levomethadyl acetate with other drugs that can prolong the QT interval is considered contraindicated.

References

  1. "Product Information. Orlaam (levomethadyl acetate)." Roxane Laboratories Inc PROD (2001):
  2. Deamer RL, Wilson DR, Clark DS, Prichard JG "Torsades de pointes associated with high dose levomethadyl acetate (ORLAAM)." J Addict Dis 20 (2001): 7-14
  3. Krantz MJ, Mehler PS "Synthetic opioids and QT prolongation." Arch Intern Med 163 (2003): 1615; author reply 1615
  4. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  5. EMA. European Medicines Agency. European Union "EMA - List of medicines under additional monitoring. http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/document_listing/document_listing_000366.jsp&mid=WC0b01ac058067c852" (2013):
View all 5 references
Major

levomethadyl acetate lumefantrine

Applies to: Orlaam (levomethadyl acetate) and Coartem (artemether / lumefantrine)

Using levomethadyl acetate together with lumefantrine 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). 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 either of 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

levomethadyl acetate food

Applies to: Orlaam (levomethadyl acetate)

Do not consume grapefruit or grapefruit juice during treatment with levomethadyl acetate unless directed otherwise by your doctor. Grapefruit juice may increase the blood levels of levomethadyl acetate. This 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). You should also avoid alcohol during treatment, as it may add to the central nervous system effects of levomethadyl acetate and increase the risk of serious side effects such as respiratory depression, low blood pressure, fainting, coma, and even death. Do not drive, operate machinery, or perform other hazardous activities until you know how the medication affects you. 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. 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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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.