Indications
Lumefantrine is an antimalarial medicine. It is always used together with Artemether in a fixed combination tablet to treat uncomplicated malaria caused by Plasmodium falciparum, including strains resistant to Chloroquine. It is not used to prevent malaria or to treat severe malaria.
How It Works
Malaria parasites live inside red blood cells and digest haemoglobin, which releases a toxic substance called haem. Lumefantrine stops the parasite from making haem harmless, so the parasite is poisoned. Artemether acts very quickly to reduce the number of parasites, while Lumefantrine stays in the blood longer and clears the parasites that remain.
Dosage and Administration
For adults and children over 35 kg using the common 20 mg Artemether and 120 mg Lumefantrine tablet, the usual course is 4 tablets per dose, given as 6 doses over 3 days: the first dose at diagnosis, the second 8 hours later, then twice daily on the next 2 days. Children’s doses depend on body weight and are set by the doctor. Take each dose with food or milk containing fat, which helps absorption. If vomiting happens within 1 hour, repeat the dose. Complete the full course.
Interactions
- Medicines that can prolong the QT interval of the heart, such as some antiarrhythmics, Quinine, Mefloquine, macrolide antibiotics, fluoroquinolones and some antipsychotics, should be avoided or used with caution.
- Strong enzyme inducers such as Rifampicin, Carbamazepine, Phenytoin and St John’s Wort reduce its effect.
- Ketoconazole and grapefruit juice may increase blood levels.
- It may reduce the effect of hormonal contraceptives; use an extra barrier method.
Contraindications
- Allergy to Lumefantrine or Artemether.
- Severe malaria.
- Known QT prolongation, a family history of sudden cardiac death, serious heart rhythm problems or low potassium or magnesium.
- The first trimester of pregnancy, unless the doctor decides it is necessary.
Side Effects
Common effects include headache, dizziness, weakness, loss of appetite, nausea, vomiting, stomach pain, joint and muscle pain, cough and sleep problems. Many of these may also be caused by malaria itself.
Get urgent medical help if you notice a fast or irregular heartbeat, fainting, severe vomiting so you cannot keep the dose down, symptoms that get worse, or swelling of the face or throat or trouble breathing.
Pregnancy and Lactation
It may be used in the second and third trimesters, and in the first trimester when the doctor decides it is necessary. Small amounts may pass into breast milk; ask your doctor before breastfeeding.
Precautions and Warnings
- Tell your doctor about heart, liver or kidney disease.
- If fever returns after treatment, get tested again.
- Dizziness may affect driving.
Overdose
An overdose may affect heart rhythm. Seek emergency medical help; heart monitoring may be needed.
Therapeutic Class
Antimalarial (aryl amino alcohol), used in artemisinin based combination therapy.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.