Artemether

Artemether is an antimalarial agent used for the treatment of acute, uncomplicated malaria caused by Plasmodium falciparum and mixed infections including P. falciparum. It is effective against both drug-sensitive and drug-resistant P. falciparum parasites.

Artemether is a derivative of artemisinin and acts rapidly as a blood schizontocide. It is not used for malaria prophylaxis or for treating severe malaria complications. It is typically administered with lumefantrine to improve efficacy and prevent resistance.

Common side effects include headache, dizziness, muscle pain, joint pain, nausea, and loss of appetite.

• Acute, uncomplicated malaria caused by Plasmodium falciparum
• Mixed malaria infections including P. falciparum
• Effective against chloroquine-resistant malaria parasites

Artemether is a derivative of naturally occurring artemisinin. It is a sesquiterpene lactone with an endoperoxide bridge, which is responsible for its antimalarial activity.

Artemether reacts with heme (iron-containing porphyrin) in the parasite's food vacuole, generating cytotoxic free radicals that damage parasite proteins and membranes. Lumefantrine interferes with the polymerization of heme into non-toxic hemozoin.

Artemether generates reactive oxygen species within the malaria parasite, damaging its proteins and membranes. Lumefantrine prevents the parasite from detoxifying heme. Together, they rapidly kill the parasite and resolve malaria symptoms.

Adults and children (≥35 kg): 6-dose regimen: 4 tablets at 0, 8, 24, 36, 48, and 60 hours (total 24 tablets).

Children (25-35 kg): 3 tablets per dose (total 18 tablets).

Children (15-25 kg): 2 tablets per dose (total 12 tablets).

Children (5-15 kg): 1 tablet per dose (total 6 tablets).

Each tablet contains 20 mg artemether and 120 mg lumefantrine. Take with food (especially fatty food or milk) to enhance absorption. Repeat dose if vomiting occurs within 1 hour.

Take this medicine with food (especially fatty food or milk). Complete the full course as prescribed by your doctor.

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.

• Headache
• Dizziness
• Muscle and joint pain
• Nausea and vomiting
• Loss of appetite
• Asthenia
• Cough

Serious Precautions:

• Artemether is not indicated for malaria prophylaxis.
• Not evaluated for severe malaria (cerebral malaria, pulmonary edema, renal failure).
• Contraindicated in the first trimester of pregnancy.
• Avoid use during breastfeeding (due to lumefantrine's long half-life).
• Use with caution in patients at risk of QT prolongation (cardiac arrhythmias, electrolyte imbalances).
• May cause dizziness and sleepiness - use caution while driving or operating machinery.
• Regular blood tests may be required to monitor parasite clearance.

• Hypersensitivity to artemether or lumefantrine
• Severe malaria (as per WHO definition)
• First trimester of pregnancy
• Family history or clinical conditions causing QT prolongation (cardiac arrhythmias, severe bradycardia)
• Electrolyte imbalances (hypokalemia or hypomagnesemia)
• Concomitant use with drugs metabolized by CYP2D6

• CYP3A4 Inhibitors: May reduce artemether metabolism, increasing blood levels.
• Drugs that prolong QT interval: May increase risk of adverse effects.
• Consult your doctor for a complete list of drug interactions.

Taking with fatty food or milk enhances absorption. Alcohol consumption should be avoided.

[CONSULT YOUR DOCTOR] Contraindicated in the first trimester. May be used in the second and third trimesters only if necessary and under medical supervision.

[CONSULT YOUR DOCTOR] Breastfeeding is not recommended for 28 days after the last dose due to lumefantrine's long elimination half-life.

Insufficient data for children weighing less than 5 kg; use with caution.

Insufficient data for patients over 65 years; use with caution.

Patients with acute renal failure may have increased artemether exposure; use with caution.

No dose adjustment needed for hepatic impairment.

In case of overdose, provide symptomatic and supportive treatment. Monitor ECG and blood potassium levels.

Store below 30°C, away from light and moisture. Keep out of reach of children.

Artemether (C₁₆H₂₆O₅)