Artemether + Lumefantrine

Indications

Artemether + Lumefantrine is used for: Acute uncomplicated malaria, Falciparum malaria

Adult Dose

Oral Adults (weighing 35 kg and above): Administer 24 tablets over 3 days; use a 3-day treatment schedule with total of 6 doses. Day 1: 4 tablets initially and 4 tablets again after 8 hours. Days 2 & 3: 4 tablets BID (morning & evening).

Child Dose

Oral Children (weighing 35 kg and above or more than 12 years of age): Administer 24 tablets over 3 days; use a 3-day treatment schedule with total of 6 doses. Day 1: 4 tablets initially and 4 tablets again after 8 hours. Days 2 & 3: 4 tablets BID (morning & evening). Children: < 12 years 5 to <15 kg: Administer 6 tablets over 3 days; 1 tablet initially and again after 8 hours on first day; follow by 1 tablet BID (morning & evening) for the next 2 days. 15 to <25 kg: Administer 12 tablets over 3 days; 2 tablets initially and again after 8 hours on first day; follow by 2 tablets BID (morning & evening) for the next 2 days. 25 to <35 kg: Administer 18 tablets over 3 days; 3 tablets initially and again after 8 hr on 1st day; follow by 3 tablets BID (morning & evening) for the next 2 days.

Renal Dose

Administration

Should be taken with food.

Contra Indications

Hypersensitivity.

Precautions

Pregnancy and lactation. Avoid concomitant use of drugs known to prolong QT interval or monitor such patients. Lactation: not known if either component enters breast milk, use caution

Pregnancy-Lactation

Interactions

Artemether causes QT prolongation in some patients. Thus concomitant use of erythromycin, terfenadine, procainamide, quinidine, disopyramide, amiodarone, bretylium, bepridil, sotalol, astemizole, probucol, tricyclic antidepressants, phenothiazines may be avoided.

Adverse Effects

Side effects of Artemether + Lumefantrine : >10% Abdominal pain (17%),Anorexia (40%),Arthralgia (34%),Asthenia (38%),Chills (23%),Dizziness (39%),Fatigue (17%),Headache (56%),Myalgia (32%),Nausea (26%),Palpitations (18%),Pyrexia (25%),Sleep disorder (22%),Vomiting(17%) 1-10% Anemia (4%),Cough (6%),Diarrhea (7%),Hepatomegaly (9%),Malaise (3%),Nasopharyngitis (3%),Pruritus (4%),Rash (3%),Splenomegaly (9%),Vertigo (3%)

Mechanism of Action

Artemether is a potent and rapidly acting blood schizontocide. Artemether and active metabolite (DHA): via endoperoxide. Lumefantrine: unknown; possibly inhibits beta-hematin formation Both artemether and lumentantrine inhibit nucleic acid and protein synthesis