CO-ARTEMETHER AND FLECAINIDE
The manufacturer of co-artemether notes that in vitro data indicate that lumefantrine significantly inhibits CYP2D6. As a consequence, they contraindicate the use of co-artemether in patients taking any drug that is metabolised by CYP2D6, and specifically name flecainide.
These contraindications seem unnecessarily restrictive, especially as flecainide is not contraindicated with other established inhibitors of CYP2D6. Until more is known, it would be prudent to closely monitor the effects of any CYP2D6 substrate in patients for whom co-artemether is considered the antimalarial drug of choice.
These contraindications seem unnecessarily restrictive, especially as flecainide is not contraindicated with other established inhibitors of CYP2D6. Until more is known, it would be prudent to closely monitor the effects of any CYP2D6 substrate in patients for whom co-artemether is considered the antimalarial drug of choice.