Coartem

Generic Name: artemether and lumefantrine (ar TEM e ther and LOO me FAN treen)
Brand Name: Coartem

What is Coartem?

Coartem contains a combination of artemether and lumefantrine. Artemether and lumefantrine are medications used to treat malaria. These medicines work by interfering with the growth of parasites in the red blood cells of the human body. Malaria is caused by parasites that enter the body through the bite of a mosquito. Malaria is common in areas such as Africa, South America, and Southern Asia.

Coartem is used to treat non-severe malaria.

Coartem is used only to treat malaria. Do not use this medicine to try to prevent malaria.

Coartem may also be used for purposes not listed in this medication guide.

Important information about Coartem

You should not use Coartem if you are allergic to artemether or lumefantrine.

Many drugs can interact with Coartem and some should not be used at the same time. Tell your doctor about all other medications you use.

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Before using Coartem, tell your doctor if you have a history of heart disease or recent heart attack, a heart rhythm disorder (especially '"Long QT syndrome), liver or kidney disease, or low levels of potassium or magnesium in your blood.

Take Coartem with food, milk, pudding, oatmeal, or broth. The tablet may be crushed and mixed with water for easier swallowing.

If you vomit within 1 to 2 hours after taking this medication, take another dose. If your vomiting continues or you cannot eat, call your doctor.

Before taking Coartem

You should not use Coartem if you are allergic to artemether or lumefantrine.

Many drugs can interact with Coartem and some should not be used at the same time. Tell your doctor about all other medications you use, especially:

• bosentan (Tracleer);

• dexamethasone (Cortastat, Dexasone, Solurex, DexPak);

• halofantrine (Halfan) taken within the past 30 days;

• St. John's wort;

• rifabutin (Mycobutin), rifampin (Rifadin, Rifater, Rifamate), or rifapentine (Priftin);

• a barbiturate such as butabarbital (Butisol), secobarbital (Seconal), pentobarbital (Nembutal), or phenobarbital (Solfoton);

• HIV/AIDS medication such as efavirenz (Sustiva, Atripla), etravirine (Intelence), nevirapine (Viramune), or ritonavir (Norvir, Kaletra);

• medicines to treat narcolepsy, such as armodafinil (Nuvigil) or modafinil (Progivil); or

• seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), phenytoin (Dilantin), or primidone (Mysoline).

To make sure Coartem is safe for you, tell your doctor if you have any of these other conditions:

• a history of heart disease or a recent heart attack;

• heart rhythm disorder, or a personal or family history of Long QT syndrome;

• liver or kidney disease; or

• low levels of potassium or magnesium in your blood.

FDA pregnancy category C. It is not known whether Coartem is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

See also: Coartem pregnancy and breastfeeding warnings (in more detail)

Use a barrier form of birth control (such as a condom or diaphragm with spermicide). Hormonal contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment.

It is not known whether artemether and lumefantrine passes into breast milk or if it could harm a nursing baby. Do not use Coartem without telling your doctor if you are breast-feeding a baby.

Coartem should not be given to a child who weighs less than 11 pounds.

How should I take Coartem?

Take Coartem exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take Coartem with food, milk, pudding, oatmeal, or broth. The tablet may be crushed and mixed with 1 or 2 teaspoons of water for easier swallowing. You may also mix a crushed tablet with infant formula when giving this medication to a child. Start eating normally as soon as possible to help your body better absorb the medication.

If you vomit within 1 to 2 hours after taking this medication, take another dose. If your vomiting continues or you cannot eat, call your doctor.

Coartem is usually given as a total of 6 doses over a period of 3 days. Carefully follow your doctor's instructions about how many tablets to take per dose. Coartem doses are based on weight and age. The usual doses are as follows, unless your doctor tells you otherwise.

For people over 16 years old who weigh at least 77 pounds:

• Take four (4) tablets as an initial dose.

• Take 4 more tablets 8 hours later.

• Take 4 tablets in the morning and 4 tablets in the evening for the next 2 days.

For children younger than 16 years old who weigh between 55 and 77 pounds:

• Take three (3) tablets as an initial dose.

• Take 3 more tablets 8 hours later.

• Take 3 tablets in the morning and 3 tablets in the evening for the next 2 days.

For children younger than 16 years old who weigh between 33 and 55 pounds:

• Take two (2) Coartem tablets as an initial dose.

• Take 2 more tablets 8 hours later.

• Take 2 tablets in the morning and 2 tablets in the evening for the next 2 days.

For children younger than 16 years old who weigh between 11 and 33 pounds:

• Take one (1) tablet as an initial dose.

• Take a second tablet 8 hours later.

• Take 1 tablet in the morning and 1 tablet in the evening for the next 2 days.

No medication is 100% effective in treating malaria. For best results, keep using the medication as directed.

Store Coartem at room temperature away from moisture and heat.

See also: Coartem dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Coartem?

Avoid taking other anti-malaria medications while you are taking Coartem, unless your doctor has told you to.

Grapefruit and grapefruit juice may interact with Coartem and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

Coartem side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Coartem: hives; fast heart rate; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

• worsening malaria symptoms;

• headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

• severe or uncontrolled vomiting or diarrhea;

• upper stomach pain, dark urine, clay-colored stools; or

• the first sign of any skin rash, no matter how mild.

Call your doctor if you develop fever, chills, body aches, severe headache, or flu symptoms after you have finished taking all your doses of Coartem.

Less serious Coartem side effects may include:

• tired feeling, mild weakness or dizziness, mild headache;

• nausea, loss of appetite;

• joint or muscle pain; or

• sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Coartem side effects (in more detail)

What other drugs will affect Coartem?

Many drugs can interact with Coartem. Below is just a partial list. Tell your doctor if you are using:

• an antibiotic such as azithromycin (Zithromax, Zmax, Z-Pack), clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), levofloxacin (Levaquin), moxifloxacin (Avelox), or pentamidine (NebuPent, Pentam);

• an antidepressant such as amitriptylline (Elavil, Vanatrip, Limbitrol), citalopram (Celexa), clomipramine (Anafranil), or nefazodone;

• antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), or voriconazole (Vfend);

• cold or allergy medicine that contains an antihistamine;

• heart rhythm medicine such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), propafenone (Rythmol), quinidine (Quin-G), and others;

• the hepatitis C medications boceprevir (Victrelis) or telaprevir (Incivek);

• medications to treat high blood pressure or high cholesterol;

• medicine to prevent or treat nausea and vomiting such as dolasetron (Anzemet) or ondansetron (Zofran);

• medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (FazaClo, Clozaril), haloperidol (Haldol), and others;

• medicines used to prevent organ transplant rejection;

• migraine headache medicine such as sumatriptan (Imitrex, Treximet) or zolmitriptan (Zomig); or

• narcotic medication such as methadone (Methadose, Diskets, Dolophine).

This list is not complete and there may be other drugs that can interact with Coartem. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Coartem.