When two or more
medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a
Drug Interaction.
Your doctor's guidelines may need to be followed while taking this medicine along with
quinine, which is used to treat
malaria. When a single dose of quinine is given intravenously with the final dose of a 6-dose regimen of Lonart ds, it results in the decreased exposure to
artemether which is not clinically significant. Patients should be cautious while using quinine and other drugs that cause heart rhythm disorder due to the long elimination half-life of
lumefantrine and the possibilities for additive QT effects.
Lonart ds Tablet interacts with hormonal contraceptives, which are used to prevent
pregnancy, and antiretroviral drugs which are used for the treatment of
HIV infection. Use of Lonart ds may decrease the effectiveness of hormonal contraceptives. Take necessary precautions while using Lonart ds in patients taking anti-retroviral drugs as it may increase the levels of
lumefantrine and further leads to QT prolongation. Lonart ds should be used cautiously in patients during anti-retroviral therapy as it may decrease the levels of the Anti-Retroviral drugs resulting in loss of efficacy. Reduction in
lumefantrine or
artemether levels may result in the loss of antimalarial potency of Lonart ds. Patients using an oral, transdermal patch, or systemic birth control measures are advised to use anti-retroviral drugs, such as
protease inhibitors and non-nucleoside reverse transcriptase inhibitors, which are known to have
competition or induction for CYP3A4.
There may be an interaction of
Lonart ds with
mefloquine, which is used to prevent or treat
malaria. When three doses of mefloquine are taken followed 12 hours later by a six-dose regimen of Lonart ds showed no effect of mefloquine on blood levels of the artemether/DHA or
artemether ratio. However, exposure to
lumefantrine was decreased, possibly due to lower absorption secondary to a mefloquine-induced reduction in the production of
bile. Proper monitoring for reduced efficacy in such patients should be done, and when Lonart ds is taken, food consumption should also be promoted.
Lonart ds Tablet may interact with
ketoconazole, which is used to treat fungal infections. When ketoconazole (a potent CYP3A4 inhibitor) is taken with a single dose of Lonart ds, it may lead to a moderate increase in exposure to
dihydroartemisinin (a metabolite of
artemether),
artemether, and
lumefantrine. Due to the potential for increased levels of
lumefantrine which could lead to heart rhythm disorder, Lonart ds should be used cautiously with drugs that block CYP3A4
enzyme.
Special instructions need to be followed while taking this medicine along with CYP2D6 substrates, which is an
enzyme and used in the treatment of mental disorders.
Lumefantrine causes blockage of CYP2D6 in vitro. When Lonart ds is given in combination with the drugs that are broken down by CYP2D6, it results in a significant increase in the blood levels of the drug given in combination and increases the risk of side effects. In addition to this, many drugs which are broken down by CYP2D6 can result in the prolonged heartbeat (prolong the QT interval). Drugs which are broken down by CYP2D6 should not be given with Lonart ds due to the possible additive effect on the QT interval including drugs such as
flecainide,
imipramine,
amitriptyline,
clomipramine.
Your doctor's guidelines may need to be followed while taking this medicine along with drugs which may cause prolonged heartbeat. The use of Lonart ds with drugs that prevent increased or decreased heartbeats of classes I A and III; neuroleptics and
antidepressant agents, certain
antibiotics may result in abnormal heart rhythm. The Lonart ds should not be used in combination with the drugs that may cause prolonged heartbeat.
Lonart ds Tablet interacts with
nevirapine, which is used to treat HIV/AIDS. Patients taking nevirapine may experience decreased levels of
artemether and
dihydroartemisinin in the blood. But the levels of
lumefantrine were not significantly reduced by nevirapine. The use of Lonart ds may lower the blood levels of nevirapine. Take necessary precautions while using Lonart ds in patients taking nevirapine.
Special instructions need to be followed while taking this medicine along with lopinavir/ritonavir, which is used to treat HIV/AIDS. The use of
lopinavir and
ritonavir reduced the absorption of
artemether and
DHA by approximately 40% but increased the absorption to
lumefantrine by about 2.3- fold. Patients taking lopinavir or ritonavir should take necessary precautions while using Lonart ds.
There may be an interaction of
Lonart ds with
efavirenz, which is used to treat HIV/AIDS. Efavirenz reduces the absorption of
artemether,
DHA, and
lumefantrine by approximately 50%, 45%, and 20%, respectively. Patients taking efavirenz should take necessary precautions while using Lonart ds.
Lonart ds Tablet may interact with drugs broken down by CYP450
enzymes. When Lonart ds is given in combination with substrates of CYP3A4, it may lead to decreased levels of the substrate and possible loss of efficacy of the substrate. Studies in
humans have also shown that
artemisinins have some capacity to induce CYP3A4 and CYP2C19 and block CYP2D6 and CYP1A2. Although the extent of the changes was generally low, it is possible that these effects could change the response of the drugs that are predominantly broken down by these
enzymes.
This page does not contain all the possible interactions of Lonart ds Tablet. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any
medicines without the approval of your doctor.