A fixed-dose artemisinin-based combination therapy (ACT) oral suspension for the treatment of acute, uncomplicated Plasmodium falciparum malaria. Arteether is a fast-acting schizonticide derived from artemisinin, providing rapid reduction of parasite biomass. Lumefantrine is a slow-acting schizonticide with a long half-life, ensuring elimination of residual parasites and preventing recrudescence. This combination is a first-line therapy as per the National Drug Policy for Malaria (2022) in India.
Adult: Total dose based on body weight. A common 3-day regimen: 4 mg/kg Arteether and 24 mg/kg Lumefantrine per day, divided into two daily doses (approx. 5ml/10kg body weight per dose, twice daily for 3 days). Example: 60kg adult takes 30ml (6 spoonfuls of 5ml each) twice daily for 3 days.
Note: MUST be administered with food or whole milk (high-fat meal) to ensure adequate absorption of Lumefantrine. Shake the bottle well before use. Use the provided measuring cup or oral syringe. The two doses on each day should be approximately 12 hours apart. Complete the full 3-day (6-dose) course even if symptoms improve.
The combination exerts a synergistic, multi-stage antimalarial effect. Arteether rapidly kills the majority of asexual blood-stage parasites (schizonts), including young ring forms, leading to a swift decrease in parasitemia and symptom relief. Lumefantrine acts more slowly on the remaining parasites, including the later trophozoite and schizont stages, ensuring complete clearance and reducing the chance of recrudescence and development of resistance.
Pregnancy: Category C (US FDA). Avoid in first trimester unless lifesaving. In second/third trimester, benefits often outweigh risks for falciparum malaria. Artemisinin derivatives are not recommended for prophylaxis in pregnancy. Consult specialist.
Driving: May cause dizziness and fatigue. Patients should not drive or operate machinery until their response is known.
| Ketoconazole, Itraconazole, Voriconazole | Increased plasma concentrations of both Arteether and Lumefantrine (CYP3A4 inhibition). Increased risk of QT prolongation. | Major |
| Rifampicin, Carbamazepine, Phenytoin, St. John's Wort | Markedly decreased plasma concentrations of Lumefantrine (CYP3A4 induction). Risk of therapeutic failure. | Major |
| Antiarrhythmics (Amiodarone, Quinidine, Sotalol), Macrolides (Erythromycin), Fluoroquinolones | Additive risk of QT interval prolongation and ventricular arrhythmias. | Major |
| Other Antimalarials (Halofantrine, Mefloquine) | Increased risk of QT prolongation. Avoid concomitant use. | Major |
| Hormonal Contraceptives | Potential reduced efficacy due to enzyme induction. Advise alternative non-hormonal methods during and for 1 month after treatment. | Moderate |
Same composition (Arteether (20mg/5ml) + Lumefantrine (120mg/5ml)), different brands: