Artemether 40 mg + Lumefantrine 240 mg Tablet (double-strength)
- Product Name: Artemether 40 mg + Lumefantrine 240 mg Tablet (double-strength)
- Packing: 10x2x6 Alu-Alu Blister
- Pack Insert/Leaflet: Yes
- Dosage Form: swallow whole; not dispersible
- Packaging: Blister packs (commonly 6, 12, or 24 tablets per pack)
- Storage: Below 30 °C; protect from moisture/light; keep out of reach of children
- Therapeutic Category: Artemisinin-based Combination Therapy (ACT) for uncomplicated malaria (primarily Plasmodium falciparum)
A double-strength fixed-dose combination designed to reduce pill burden compared with the 20/120 mg tablet. Artemether provides rapid parasite clearance, and lumefantrine provides a longer tail to prevent recrudescence. Must be taken with fatty food (e.g., milk, porridge, meal) to ensure adequate lumefantrine absorption.
Active Ingredients:
Artemether (40 mg) – fast-acting artemisinin derivative; quickly lowers parasitemia.
Lumefantrine (240 mg) – long half-life partner; clears residual parasites.
Mechanisms:
Artemether (via DHA) produces reactive intermediates that damage parasite proteins.
Lumefantrine interferes with heme handling/polymerization within the parasite.
Onset: Clinical improvement typically within 24–48 h; fever/parasitemia fall rapidly.
Artemether (40 mg) – fast-acting artemisinin derivative; quickly lowers parasitemia.
Lumefantrine (240 mg) – long half-life partner; clears residual parasites.
Mechanisms:
Artemether (via DHA) produces reactive intermediates that damage parasite proteins.
Lumefantrine interferes with heme handling/polymerization within the parasite.
Onset: Clinical improvement typically within 24–48 h; fever/parasitemia fall rapidly.
Treatment of acute uncomplicated malaria due to P. falciparum (including mixed infections where P. falciparum is suspected/confirmed).
Suitable where oral therapy is feasible (not for severe/complicated malaria—use parenteral therapy first).
Suitable where oral therapy is feasible (not for severe/complicated malaria—use parenteral therapy first).
Total course: 6 doses over 3 days (0, 8, 24, 36, 48, 60 hours).
Administration: Take with food; if vomiting occurs within 1 hour, repeat the dose. Maintain hydration.
Weight-Based Dosing using 40/240 mg tablets
5 to <15 kg: Use 20/120 mg tablets (this strength is generally not used in this band).
15 to <25 kg: 1 tablet per dose × 6 doses (total 6 tablets).
25 to <35 kg: 1.5 tablets per dose × 6 doses (total 9 tablets).
Practical options: alternate 1 and 2 tablets per dose as per clinician/pharmacist guidance, or use a mix with 20/120 mg to avoid splitting.
≥35 kg (adolescents/adults): 2 tablets per dose × 6 doses (total 12 tablets).
Dose equivalence note:
Standard adult regimen with 20/120 mg is 4 tablets per dose × 6.
With 40/240 mg (double-strength), this becomes 2 tablets per dose × 6.
Administration: Take with food; if vomiting occurs within 1 hour, repeat the dose. Maintain hydration.
Weight-Based Dosing using 40/240 mg tablets
5 to <15 kg: Use 20/120 mg tablets (this strength is generally not used in this band).
15 to <25 kg: 1 tablet per dose × 6 doses (total 6 tablets).
25 to <35 kg: 1.5 tablets per dose × 6 doses (total 9 tablets).
Practical options: alternate 1 and 2 tablets per dose as per clinician/pharmacist guidance, or use a mix with 20/120 mg to avoid splitting.
≥35 kg (adolescents/adults): 2 tablets per dose × 6 doses (total 12 tablets).
Dose equivalence note:
Standard adult regimen with 20/120 mg is 4 tablets per dose × 6.
With 40/240 mg (double-strength), this becomes 2 tablets per dose × 6.
Cardiac: Risk of QT prolongation; avoid concomitant QT-prolonging drugs and correct electrolytes.
Drug Interactions: CYP3A4/CYP2D6 inhibitors/inducers can alter exposure; avoid grapefruit products; review concomitant meds (antiretrovirals, macrolides, azoles, some antidepressants, antiarrhythmics).
Contraception: May reduce hormonal contraceptive effectiveness; advise additional contraception during treatment.
Hepatic/Renal: Caution in severe hepatic impairment; no routine adjustment in mild-to-moderate impairment.
Pregnancy/Lactation: Generally acceptable in 2nd/3rd trimesters for uncomplicated malaria; follow local/National guidelines.
Not for severe malaria: If severe disease is suspected, initiate injectable artesunate and step down to oral ACT when stable.
Drug Interactions: CYP3A4/CYP2D6 inhibitors/inducers can alter exposure; avoid grapefruit products; review concomitant meds (antiretrovirals, macrolides, azoles, some antidepressants, antiarrhythmics).
Contraception: May reduce hormonal contraceptive effectiveness; advise additional contraception during treatment.
Hepatic/Renal: Caution in severe hepatic impairment; no routine adjustment in mild-to-moderate impairment.
Pregnancy/Lactation: Generally acceptable in 2nd/3rd trimesters for uncomplicated malaria; follow local/National guidelines.
Not for severe malaria: If severe disease is suspected, initiate injectable artesunate and step down to oral ACT when stable.
Common: Headache, dizziness, loss of appetite, nausea, vomiting, abdominal pain, palpitations, cough, myalgia, arthralgia, fatigue, insomnia.
Pediatric considerations: Irritability, fever, rash, pruritus may occur.
Serious (rare): Hypersensitivity reactions, significant QT prolongation/arrhythmia.
Pediatric considerations: Irritability, fever, rash, pruritus may occur.
Serious (rare): Hypersensitivity reactions, significant QT prolongation/arrhythmia.
Commonly referred to as double-strength artemether–lumefantrine.
Brand names vary by market (e.g., DS versions of established AL brands).
Brand names vary by market (e.g., DS versions of established AL brands).
Double-strength tablet reduces pill burden vs. 20/120 mg.
Must be taken with fatty food to ensure efficacy (lumefantrine absorption).
Delivers high cure rates when the 6-dose regimen is completed correctly.
Not a substitute for parenteral therapy in severe malaria; use as first-line for uncomplicated cases.
Must be taken with fatty food to ensure efficacy (lumefantrine absorption).
Delivers high cure rates when the 6-dose regimen is completed correctly.
Not a substitute for parenteral therapy in severe malaria; use as first-line for uncomplicated cases.