COARTEM DISPERSIBLE 20/120MG TABLET

Indications

• Uncomplicated Plasmodium falciparum malaria
• Malaria prophylaxis in certain high-risk populations

Dosage

Children: For children aged 5 to 14 years, the recommended dose is based on body weight and is generally 1 to 2 tablets (based on the same composition) taken twice daily for 3 days. Please refer to the BNF for Children for specific guidance.

Adults: The usual adult dose is 4 tablets (containing 20 mg of artemether and 120 mg of lumefantrine) taken twice daily for 3 days.

Mechanism of action

Artemether acts by producing free radicals that damage the parasite's proteins and membranes, leading to cell death. Lumefantrine, on the other hand, inhibits the beta-haematin formation, which is essential for the parasite's survival and replication. Together, these components disrupt the life cycle of the malaria parasite, aiding in the rapid clearance of the infection.

Pharmacodynamics

Coartemether exerts its effects by targeting both the asexual blood stages of the malaria parasite. The combination therapy helps to reduce the risk of resistance development, as the two drugs have different mechanisms of action. The rapid onset of action is beneficial, providing symptomatic relief and lowering parasitemia levels quickly.

Pharmacokinetics

Following oral administration, artemether is rapidly absorbed with peak plasma concentrations occurring within 2 hours, while lumefantrine is absorbed more slowly, with peak concentrations typically occurring around 6 to 10 hours post-dose. Both drugs are extensively metabolized in the liver, primarily by cytochrome P450 enzymes, and are excreted mainly in the faeces. The elimination half-life of artemether is approximately 2 to 3 hours, while lumefantrine has a longer half-life of around 3 to 6 days.

Contra-indications

• Hypersensitivity to artemether, lumefantrine, or any excipients
• Severe hepatic impairment
• Severe malaria requiring parenteral treatment

Adverse effects

• Headache
• Dizziness
• Nausea
• Vomiting
• Fatigue
• Palpitations
• QT interval prolongation
• Anemia
• Hypersensitivity reactions

Interactions

• Caution with drugs that prolong the QT interval
• Potential interaction with CYP3A4 inhibitors or inducers
• May enhance the effects of anticoagulants

Precautions

• Monitor for signs of hypersensitivity reactions
• Use with caution in patients with a history of cardiac arrhythmias
• Consider alternative treatment in cases of severe malaria
• Monitor liver function in patients with hepatic impairment

Pregnancy

Use only if the potential benefit justifies the potential risk to the fetus. Consult local guidelines.

Breast-feeding

Use with caution. Monitor the infant for any adverse effects.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Formulations

• Coartemether tablets (artemether/lumefantrine combination)
• Coartemether oral suspension