with dose, precaution, patient information, side effects, contraindication
You must realize that lumefantrine alone is no longer available. This is what I found for you.
The tale of co-Artemether
A drug called lumefantrine also comes from the Chinese formulary, having been synthesized at the Academy of Military Medical Sciences in Beijing. It has a similar structure and activity to mefloquine, an antimalarial widely used in Southeast Asia, but it must be administered with food that is high in fat content in order to be absorbed. This drawback is also shared by one of the artemisinins called artemether. As a result, the Chinese researchers combined the two as ‘co-artemether’, which was registered for the oral treatment of malaria in China in 1987.
Clinical trials using a four-dose course of co-artemether, which was effective in much of Asia, were disappointing in Africa. Studies in Thailand found that for the treatment to be effective in more difficult settings, a six-dose regimen was necessary and the combination needed to be dosed in a very particular way.
Firstly, the co-artemether must be taken with fatty food (at least 23 grams of fat per dose), which could be difficult for anyone (usually a child) suffering from fever and nausea. In addition, the dosing interval could be confusing.
The second dose must be taken precisely eight hours after the first dose to maximise the blood levels of lumefantrine (which have been shown to be vital for a sustained response). The third dose must be taken 24 hours after the second dose and the three subsequent doses must be taken every twelve hours.
These dosing requirements provoked questions as to the practicality of co-artemether without clinical supervision in many African settings. Therefore, to make things simpler, the World Health Organisation developed a blister pack for the combination, with dose adjusted by weight. The blister packs have images on them in order to illustrate to the parents how and when the tablets should be given.
Even though co-artemether was still relatively untested in 'real world' African settings, the general consensus is that using it (or other ACTs) would be preferable to using chloroquine or SP where they were failing. There were calls from many quarters, including WHO, for countries to switch to ACTs.
Still, few African countries could afford the new drugs (at present, co-artemether is one of the most expensive treatment options available costing 10 to 20 times more than the old drugs — see discussion below).
If countries could not afford ACTs, WHO recommended using a combination of amodiaquine plus SP as a much cheaper, though perhaps a short-term option. Amodiaquine is a potent malarial still used as a monotherapy in some settings. Still, it is quite similar to chloroquine, and although it is active against some chloroquine-resistant strains, there is some cross-resistance.
Hope this helps
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