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Artemether

  • Brand Names: Coartem (a widely known brand), among others.
  • Formulation: Available as dispersible tablets (for easier administration in children) and regular tablets.
  • Combination:
    • Artemether: A fast-acting artemisinin derivative, known for its rapid action against the malaria parasite.
    • Lumefantrine: A longer-acting drug that helps to clear the remaining malaria parasites after artemether has acted quickly.
  • Recommended Usage
Indication:

Artemether + Lumefantrine is used to treat uncomplicated Plasmodium falciparum malaria, which includes:

  • Acute Malaria: Used in treating patients who are infected with this strain of the malaria parasite.
  • Prevention of Malaria: Sometimes used in the prevention of malaria, especially in areas with high transmission rates.

It is typically used for uncomplicated malaria cases and is not recommended for severe or complicated malaria (e.g., cerebral malaria or severe anemia).

Dosage:

The dosing schedule is usually based on the age and weight of the patient. For dispersible tablets, the dose may vary, but here is a general guide:


Adults and Children (over 5 years, weighing 35 kg or more):

  • Artemether (20 mg) + Lumefantrine (120 mg): 1 tablet (or according to weight) twice a day for 3 days.
    • The usual dosing is to take the first dose immediately, then take another dose 8 hours later, followed by twice-daily dosing for the next two days.

Children (under 5 years):

  • Dosing depends on weight:Children’s dosage is adjusted based on their body weight, and the treatment typically lasts for 3 days.
  • For Example (in children under 5 years):
    • Weight 5–14 kg: 1 tablet twice a day.
    • Weight 15–24 kg: 2 tablets twice a day.
    • Weight 25–34 kg: 3 tablets twice a day.

It's important to follow the exact dosing schedule as prescribed by your healthcare provider. The tablets should be taken with food to increase absorption and effectiveness.

Precautions:
  • Use in Pregnancy: The safety of this combination during pregnancy, especially in the first trimester, should be carefully considered. It is typically only recommended when the benefits outweigh the potential risks. Consult with a healthcare provider before using it during pregnancy.
  • Liver or Kidney Impairment: Caution is required for patients with liver or kidney conditions. The dosage may need to be adjusted, and the patient should be closely monitored.
  • Cardiovascular Effects: Both artemether and lumefantrine can prolong the QT interval (which can affect the heart’s rhythm), so this medication should be used with caution in people with heart disease or those taking other drugs that may cause QT prolongation.
  • Co-administration with Other Medications: This combination may interact with other medications, particularly those that affect liver enzymes (CYP3A4 inhibitors or inducers). Always inform your doctor about any other medications you are taking.
  • Drug Resistance: While this combination is effective, there is the possibility of drug resistance developing, especially if treatment is incomplete or improperly followed. Ensure the full course is completed, even if symptoms improve.
  • Severe Malaria: Not recommended for the treatment of severe or complicated malaria, which requires intravenous medications and more intensive management.
  • Parasite Clearance: Treatment should result in a significant decrease in fever within 48–72 hours. If symptoms persist or worsen, consult your healthcare provider.
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