Description
Uses and Administration
Lumefantrine is a dichlorobenzylidine derivative given by mouth in combination with artemether for the treatment of uncomplicated falciparum malaria. It is a blood schizontocide with a relatively slow onset of action but it has a longer duration of action than artemether.
Artemisinin is a sesquiterpene lactone isolated from Artemisia annua, a herb that has traditionally been used in China for the treatment of malaria. It is a potent and rapidly acting blood schizontocide active against Plasmodium vivax and against both chloroquine-sensitive and chloroquine-resistant strains of P. falciparum.
Artemisinin has been given orally or rectally in the treatment of malaria; regimens were often empirical with typical oral doses ranging from 10 to 25 mg/kg daily over a variable number of days.? However, it has largely been replaced in practice by its derivatives artemether and artesunate.
The following doses are recommended by WHO for the treatment of uncomplicated falciparum malaria.
Artesunate, when used with other antimalarials (amodiaquine, mefloquine, or pyrimethamine-sulfadoxine), is given orally to adults and children in a dose of 4 mg/kg daily, as a single dose, for 3 days.
Artemether is given orally with lumefantrine; 6 doses in total are given, the first at diagnosis and repeated after 8, 24, 36, 48, and 60 hours. Each dose is:
- adults and children weighing over 34 kg, artemether 80 mg with lumefantrine 480 mg
- children 5 to 14 kg, artemether 20 mg with lumefantrine 120 mg
- children 15 to 24 kg, artemether 40 mg with lumefantrine 240 mg
- children 25 to 34 kg, artemether 60 mg with lumefantrine 360 mg
For parenteral use in severe malaria, WHO recommends:
for adults or children, artesunate 2.4 mg/kg intravenously or intramuscularly, repeated after 12 and 24 hours and then once daily thereafter
as an alternative in children, artemether 3.2 mg/kg intramuscularly, followed by 1.6 mg/kg daily thereafter. For both drugs the patient should be transferred to oral therapy as soon as possible
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