Lumefantrine and Nevirapine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Nevirapine
Lumefantrine
No brand names on record
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
Reduced artemether/lumefantrine exposure, reduced efficacy of artemether/lumefantrine, and loss of antimalarial efficacy
Interaction Deep Dive
Use caution when artemether/lumefantrine is coadministered with CYP3A4 inducers, such as nevirapine, as this may reduce artemether/ lumefantrine exposure1.
Why it happens (mechanism)
Induction of CYP3A4-mediated metabolism of artemether/lumefantrine
Literature reports
1 report — tap to read
a) In an open-label, pharmacokinetic study, concomitant use of artemether/lumefantrine with nevirapine significantly decreased artemether and dihydroartemisinin (active metabolite) concentrations, and unexpectedly increased lumefantrine plasma concentrations. Among enrolled adult HIV-infected patients, 18 were receiving nevirapine and 18 were naive to antiretroviral therapy (ART). With the first artemether/lumefantrine dose (0 to 8 hours), the median artemether AUC was 4-fold lower in the nevirapine group (38.9 (range, 18 to 142) nanograms (ng) x hr/mL) compared with the ART-naive group (151 (range, 41.1 to 474) ng x hr/mL) (p less than 0.0001); artemether Cmax was 10-fold lower in the nevirapine group (5.8 (range, 2.89 to 47.8) ng/mL) compared with the ART-naive group (59.7 (range, 13.5 to 140) ng/mL) (p less than 0.0001). Surprisingly, median lumefantrine concentrations were significantly higher in the nevirapine group (622 ng/mL (range, 185 to 2,040 ng/mL)) compared with the ART-naive group (336 ng/mL (range, 29 to 934 ng/mL)) (p=0.0002). With the last artemether/lumefantrine dose (60 to 68 hours), the median artemether AUC was nonsignificantly reduced in the nevirapine group compared with the ART-naive group (p=0.12). The median artemether Cmax was still significantly lower in the nevirapine group (5.2 (range, 2.3 to 29.9) ng/mL) compared with the ART-naive group (11.9 (range, 2.9 to 107) ng/mL) (p=0.015). The median dihydroartemisinin AUC was also significantly reduced in the nevirapine group (125 (range, 48.3 to 290.3) ng x hr/mL) compared with the ART-naive group (165.7 (range, 72.4 to 728.7) ng x hr/mL) (p=0.01). Overall, there were no serious adverse events 2.
Common questions
Can I take Lumefantrine and Nevirapine together?
Reduced artemether/lumefantrine exposure, reduced efficacy of artemether/lumefantrine, and loss of antimalarial efficacy Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lumefantrine and Nevirapine 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 "established". Well documented — supported by controlled studies or strong clinical data.
Questions for your pharmacist
- Does my dose of Lumefantrine or Nevirapine 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: COARTEM® oral tablets, artemether lumefantrine oral tablets. Novartis Pharmaceuticals Corporation (per DailyMed), East Hanover, NJ, 2025. DailyMed
- Kredo T, Mauff K, Van der Walt JS, et al: Interaction between Artemether-Lumefantrine and Nevirapine-Based Antiretroviral Therapy in HIV-1-Infected Patients. Antimicrob Agents Chemother 2011; 55(12):5616-5623. PubMed
Keep reading about Nevirapine
Keep reading about Lumefantrine
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist