Composition
Inj 40 mg/80 mg: Artemether 40 mg/80 mg; amp. Inj paeds 20 mg: Artemether 20 mg; amp. Cap 40 mg: Artemether 40 mg.
Indications & Dosage
Severe malaria including cerebral malaria and as a second line treatment in chloroquine-resistant falciparum malaria: BY IM INJ OR IV INF: Adults: 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 below 7 yr age: 1.5 mg/kg; 7 yrs or above, same as adult dose. Both the age group children should be given the second 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. Dissolve 60 mg of Artesunate with 1 ml of 5% sodium bicarbonate solution for injection before use in IM injection. Dissolve 60 mg of Artesunate with 1 ml of 5% sodium bicarbonate solution for IV infusion 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 occur, it should be rejected.
Contraindications
Family history of congenital QT interval prolongation family history of sudden death. history of arrhythmias. history of clinically relevant bradycardia .history of congestive heart failure accompanied by reduced left ventricular ejection fraction Electrolyte disturbances, concomitant use with other drugs known to cause QT-interval prolongation.
Precautions
Avoid in acute porphyrias, history of arrhythmias, electrolyte disturbances, bradycardia, congestive heart failure accompanied by reduce ventricular ejection fraction; family history of sudden death or of congenital QT interval prolongation.
Interactions
Antioxidant drugs e.g. vitamin E, C. Additive Chloroquine, antagonistic effect seen with pyrimethamine and sulphonamides
Pregnancy
Contraindicated in pregnancy.
Lactation
Caution advised or effect undetermined.
Side 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.