Artemether

Antimalarial · Artemisinin derivative

Indications

Severe malaria including cerebral malaria and as a second line treatment in chloroquine resistant falciparum malaria.

Dosage

Adults: IM or IV infusion: First dose 120 mg; followed by 60 mg after 4-6 hr; then 60 mg after every 24 hr once daily. The total duration of treatment is 5 consecutive days. Total doses are 360-480 mg for adults. Children: IM or IV infusion: Age 7 yr or more, same as adult dose. Below 7 yr age: 1.5 mg/kg. Both the age group children should be given the sec dose after 4-6 hr; then one dose after every 24 hr once daily. The total duration of treatment is 5 consecutive days.

Administration

Deep IM injection or slow IV infusion. IM injection: Dissolve 60 mg of Artemether with 1 mL of 5% sodium bicarbonate solution for injection before use. IV infusion: Dissolve 60 mg of Artemether with 1 mL of 5% sodium bicarbonate solution for injection and add 5 mL of 0.9% sodium chloride solution for injection before use to make 1 mL containing 10 mg of Artesunate. Injection must follow immediately soon after dissolution, if the solution appears cloudy or sediment occurs, it should be rejected.

Adverse Effects

Transient and reversible reticulocytopenia, drug fever, drug rash, bradycardia, transient first degree heart block and transient & reversible elevation of serum transaminases. Nausea, abdominal pain, diarrhoea, headache.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Caution advised or effect undetermined. Contraindications: Electrolyte disturbances, concomitant use with other drugs known to cause QT-interval prolongation. Precautions: History of arrhythmias, of clinical relevant bradycardia and of congestive heart failure accompanied by reduced ventricular ejection fraction; family history of sudden death or of congenital QT interval prolongation.

Interactions

Antioxidant drugs e.g. vitamin E, C. Additive effect seen with chloroquine. Antagonistic effect seen with pyrimethamine and sulphonamides.

Pharmacokinetics

Absorption: Rapidly absorbed. Metabolism: Hepatic. Half-life elimination: 2-12 hrs. Time to peak, plasma: 2 hrs.

Brands with this active ingredient

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