Artemether + Lumefantrine

Artemether + Lumefantrine is a combination antimalarial 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 an artemisinin derivative and Lumefantrine is a synthetic racemic fluorine mixture. Both components act on the parasite's food vacuole. Artemether reacts with heme to generate cytotoxic radicals while Lumefantrine interferes with heme polymerization.

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

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

This preparation contains Artemether and Lumefantrine in a 1:6 ratio. Artemether is an artemisinin derivative. Lumefantrine is a synthetic racemic fluorine mixture belonging to the aryl amino alcohol family (like quinine, mefloquine, halofantrine).

Both components act in the malarial parasite's food vacuoles. Lumefantrine interferes with the polymerization process, while Artemether generates reactive metabolites through interaction between the peroxide bridge and heme iron. Both also inhibit nucleic acid-protein synthesis in the parasite.

Artemether reacts with heme to generate cytotoxic free radicals that damage parasite proteins and membranes. Lumefantrine prevents heme polymerization into non-toxic hemozoin, causing toxic heme accumulation. Together, they rapidly kill the parasite and stop infection spread.

Weight-based Dosing:

• ≥35 kg: 6-dose course (total 24 tablets) - 4 tablets initially, 4 after 8 hours, then 4 tablets twice daily for 2 days
• 25-35 kg: 3 tablets per dose (total 18 tablets)
• 15-25 kg: 2 tablets per dose (total 12 tablets)
• 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.

Take this medicine with food (especially fatty food or milk). Complete the full course as prescribed. Repeat dose if vomiting occurs within 1 hour.

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
• Loss of appetite
• Weakness
• Muscle and joint pain
• Nausea and vomiting
• Abdominal pain
• Diarrhea
• Rash
• Cough
• Abnormal gait

Serious Precautions:

• Not indicated for malaria prophylaxis.
• Not evaluated for cerebral malaria or severe malaria complications.
• Contraindicated in the first trimester of pregnancy.
• Avoid use during breastfeeding - discontinue breastfeeding for 28 days after last dose.
• Use with caution in patients at risk of QT prolongation.
• May cause dizziness - use caution while driving or operating machinery.
• If vomiting occurs within 1 hour, take another dose.
• Inform your doctor if you have kidney, liver, or heart disease.

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

• CYP3A4 Inhibitors: May reduce artemether metabolism, increasing blood levels.
• Drugs that prolong QT interval: May increase risk of adverse effects.

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] Due to lumefantrine's long half-life (4-6 days), breastfeeding should not resume until day 28 after the last dose unless benefits outweigh risks.

Safety and efficacy not established for children weighing <5 kg. Dosing table available for 5-15 kg, 15-25 kg, and 25-35 kg.

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

Use with caution in severe kidney disease. No dose adjustment recommended.

Use with caution in severe liver disease. No dose adjustment recommended.

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) + Lumefantrine (C₃₀H₃₂ClF₃N₂O)