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Artemether and Lumefantrine use while Breastfeeding

Artemether and Lumefantrine Levels and Effects while Breastfeeding

Summary of Use during Lactation

Artemether and lumefantrine have not been studied in nursing mothers. Estimates of its excretion into breastmilk indicate that amounts in milk are very low. The Centers for Disease Control and Prevention consider the drug combination acceptable for use in mothers nursing an infant weighing at least 5 kg (11 pounds) and it can be given directly to infants weighing 5 kg or more.[1] The safety of the combination in breastfed infants under 5 kg is not known.

Drug Levels

Maternal Levels. The excretion of artemether and lumefantrine in breastmilk was estimated from average maximum serum concentrations after a standard 6-dose regimen of artemether 40 mg and lumefantrine 240 mg daily, assuming a M/P ratio of 1.04 for artemether and 1.3 for lumefantrine. The authors estimated that a fully breastfed infant would receive 0.03 mg daily of artemether or less than 0.4% of the recommended dose for a 5 kg infant, and 5 mg daily of lumefantrine or less than 10% of the recommended dose for a 5 kg infant[2]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Atovaquone and Proguanil, Chloroquine, Mefloquine

References

1. Centers for Disease Control and Prevention. CDC Health Information for International Travel 2016. New York: Oxford University Press. 2016. wwwnc.cdc.gov/travel/page/yellowbook-home-2014

2. Adjei GO, Goka BQ, Binka F, Kurtzhals JA. Artemether-lumefantrine: an oral antimalarial for uncomplicated malaria in children. Expert Rev Anti Infect Ther. 2009;7:669-81. PMID: 19681693

3. Jain JP, Ganesan S, Lefevre G et al. Estimating of the amount of artemether and lumefantrine excreted through breast milk . Trop Med Int Health. 2015;20 (Suppl. S1):184-5. Abstract. DOI: doi:10.1111/tmi.12574

Artemether and Lumefantrine Identification

Substance Name

Artemether and Lumefantrine

CAS Registry Number

141204-94-6

Drug Class

Anti-Infective Agents

Antiparasitic Agents

Antimalarials

Antiprotozoal Agents

Administrative Information

LactMed Record Number

788

Last Revision Date

20151106

Disclaimer

Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Disclaimer: This information is not intended as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. Use of this website signifies your agreement to the Terms of Use and Online Privacy Policy.

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