Arex

Indications

Artemether is an antimalarial medicine. Tablets usually combine it with Lumefantrine to treat uncomplicated malaria caused by Plasmodium falciparum and other malaria types, including infections that do not respond to older medicines such as Chloroquine. An injection form is used in hospital for severe malaria when other treatment is not available. It is not used to prevent malaria.

How It Works

Artemether comes from the sweet wormwood plant (artemisinin family). It acts very quickly against the malaria parasites living in red blood cells, producing reactive substances that damage the parasite, so fever and parasite numbers fall fast. Its partner medicine Lumefantrine works more slowly and stays in the body longer to clear the remaining parasites and reduce the chance of the infection coming back.

Dosage and Administration

Use exactly as prescribed after malaria has been confirmed. For the combination tablet with Lumefantrine, the usual adult course is 6 doses over 3 days: a first dose, a second dose 8 hours later, then one dose twice a day for the next 2 days. The number of tablets per dose depends on body weight. Take each dose with food or milk containing some fat, which helps absorption. If vomiting occurs within an hour, repeat the dose. Finish the full course even if you feel better. Injections are given by a doctor or nurse in hospital.

Interactions

Medicines that affect heart rhythm (QT prolongation), such as some antiarrhythmics, Moxifloxacin, Erythromycin, some antipsychotics and antidepressants, and Mefloquine, should be avoided or used with care. Rifampicin, Carbamazepine, Phenytoin and St John's Wort can make it less effective. Ketoconazole and some HIV medicines can raise its level. It may reduce the effect of hormonal contraceptives; use an extra method. Grapefruit juice should be avoided.

Contraindications

Do not use if you are allergic to Artemether or Lumefantrine, or have a history of a long QT interval, serious heart rhythm problems, sudden cardiac death in the family, or low blood potassium or magnesium that has not been corrected. Tablets are not suitable for severe malaria, which needs hospital treatment.

Side Effects

Common side effects include headache, dizziness, weakness, loss of appetite, nausea, vomiting, stomach pain, joint and muscle pain, cough and trouble sleeping. Many of these can also be symptoms of malaria itself.

Get urgent medical help if fever returns or symptoms worsen, or if you have fainting, a fast or irregular heartbeat, confusion, seizures, dark urine or yellowing of the skin or eyes, very pale skin or breathlessness some weeks after treatment (possible delayed anaemia), or a serious allergic reaction.

Pregnancy and Lactation

Malaria in pregnancy is dangerous for mother and baby and must be treated. Artemether combinations are now used in all trimesters when advised by a doctor. Only small amounts pass into breast milk; ask your doctor about breastfeeding.

Precautions and Warnings

Tell your doctor about heart disease, kidney or liver problems, or other medicines you take. Eat when you can during treatment. If you travel to or live in a malaria area, also use bed nets and insect repellent. See a doctor if fever comes back after treatment.

Overdose

Overdose may affect the heart rhythm. Contact a doctor or the nearest hospital immediately; heart monitoring may be needed.

Therapeutic Class

Antimalarial, artemisinin derivative.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Injections are stored as directed on the pack.