Lumefantrine and Lefamulin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Lumefantrine
No brand names on recordLefamulin
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased artemether/lumefantrine exposure and an increased risk of QT prolongation
Interaction Deep Dive
Lefamulin (oral or IV) has the potential to prolong the QT interval in some patients. Avoid lefamulin use in patients receiving drugs that prolong the QT interval, such as artemether/lumefantrine. Monitor ECG during treatment if coadministration cannot be avoided. The magnitude of QT prolongation may increase with increasing concentration of lefamulin or increasing the rate of infusion of the IV formulation. Therefore, do not exceed recommended dose and infusion rate1. Coadministration of artemether/lumefantrine and lefamulin (CYP3A4 inhibitor) may increase artemether/lumefantrine exposure. Additionally, caution is advised when administering drugs that prolong the QT interval after completing artemether/lumefantrine therapy due to the long half-life of lumefantrine (3 to 6 days) 2.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of artemether/lumefantrine; additive QT interval prolongation
Common questions
Can I take Lumefantrine and Lefamulin together?
Increased artemether/lumefantrine exposure and an increased risk of QT prolongation Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lumefantrine and Lefamulin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Lumefantrine or Lefamulin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: XENLETA(R) oral tablets, intravenous injection, lefamulin oral tablets, intravenous injection. Nabriva Therapeutics US Inc (per FDA), King of Prussia, PA, 2021. DailyMed
- Product Information: COARTEM® oral tablets, artemether lumefantrine oral tablets. Novartis Pharmaceuticals Corporation (per DailyMed), East Hanover, NJ, 2025. DailyMed
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