Drug General Information (ID: DDIBKZSQ0P)
Drug Name			Tramadol		Drug Info		Lumefantrine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Analgesics				Antimalarial Agents
Structure

Mechanism of Tramadol-Lumefantrine Interaction (Severity Level: Major)
Increased risk of prolong QT interval Click to Show/Hide Mechanism Graph
Drug Name		Tramadol				Lumefantrine
Mechanism		Prolong QT interval				Prolong QT interval
Key Mechanism Factor 1
		Factor Name		QT interval
		Factor Description		Long QT syndrome is a heart signaling disorder that can cause a fast, chaotic heartbeat (arrhythmia). Many people may not exhibit symptoms, and usually the condition is detected during routine medical tests. In others, the most common symptoms include: sudden fainting, palpitations, dizziness, seizures, sudden death.
Mechanism Description		Increased risk of prolong QT interval by the combination of Tramadol and Lumefantrine

Recommended Action
Management		Coadministration of artemether-lumefantrine with tramadol should generally be avoided. If concomitant use is required, careful consideration of the effects on tramadol and M1 is recommended. Patients should be monitored for opioid withdrawal, seizures, and serotonin syndrome, and care should be exercised in patients suspected to be at an increased risk of torsade de pointes. If artemether-lumefantrine is discontinued, consider reducing the tramadol dose (taking into account the elimination half-life of lumefantrine [3 to 6 days]) until stable drug effects are achieved and monitor for respiratory depression and sedation. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope.

References
1	EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports.".
2	Product Information. Coartem (artemether-lumefantrine). Novartis Pharmaceuticals, East Hanover, NJ.
3	Product Information. Ultram (tramadol). McNeil Pharmaceutical, Raritan, NJ.