Sensitive CYP3A4 Substrates that Prolong QT/Oral Lefamulin Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Very Serious. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Lefamulin tablets may increase the amount of your other medicine in your blood by slowing down how quickly your liver processes the medicine. Also, both lefamulin and your other medicine may affect your heart rhythm.

What might happen:

The blood levels of your other medicine may increase and could cause more side effects, including an irregular heartbeat that may be life-threatening.

What you should do about this interaction:

Let your healthcare professionals (e.g doctor or pharmacist) know right away about your medicines. Your doctor may have to change your medicine before you start lefamulin. Let your doctor know right away if you notice an irregular heartbeat or have dizziness or fainting episodes.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Xenleta (lefamulin) US Prescribing information. Nabriva Therapeutics US, Inc August 2019.
  • 2.Drew BJ, Ackerman MJ, Funk M, Gibler WB, Kligfield P, Menon V, Philippides GJ, Roden DM, Zareba W. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. J Am Coll Cardiol 2010 Mar 2;55(9):934-47.
  • 3.American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2023 Jul;71(7):2052-2081.
  • 4.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and- drug-interactions-table-substrates-inhibitors-and-inducers. Updated 11/14/2017.
  • 5.This information is based on an extract from the Certara Drug Interaction Database (DIDB) Platform, Copyright Certara 1999-2023..
  • 6.USDepartment of Health and Human Services Food and Drug Administration. ICH E14 Clinical Evaluation of QT/QTc Interval Prolongation and Proarrhythmic Potential for Non-Antiarrhythmic Drugs. Available at: https://www.fda.gov/media/71372/download October, 2005.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.