A 45-year-old man returns from Eritrea with P. falciparum malaria (parasitaemia 1.8%, no severe features). He is HIV-positive on lopinavir/ritonavir-b...

Question

A 45-year-old man returns from Eritrea with P. falciparum malaria (parasitaemia 1.8%, no severe features). He is HIV-positive on lopinavir/ritonavir-based ART. The treating physician considers artemether/lumefantrine. What is the key drug interaction concern?

Accepted Answer

Ritonavir is a potent CYP3A4 inhibitor that increases lumefantrine levels, potentially prolonging QTc interval; ECG monitoring is advised and an alternative ACT or ART adjustment may be considered

Answer

No significant interaction exists

Answer

Lopinavir reduces artesunate absorption

Answer

Lumefantrine inactivates all protease inhibitors

Answer

The interaction only affects mefloquine, not ACTs

uk-dtmh MCQ (SBA): PI-Lumefantrine QTc Interaction

A 45-year-old man returns from Eritrea with P. falciparum malaria (parasitaemia 1.8%, no severe features). He is HIV-positive on lopinavir/ritonavir-based ART. The treating physician considers artemether/lumefantrine. What is the key drug interaction concern?