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Coartem Side Effects

Generic Name: artemether / lumefantrine

Note: This document contains side effect information about artemether / lumefantrine. Some of the dosage forms listed on this page may not apply to the brand name Coartem.

For the Consumer

Applies to artemether / lumefantrine: oral tablet

Side effects requiring immediate medical attention

Along with its needed effects, artemether / lumefantrine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking artemether / lumefantrine:

More common

  • Abdominal or stomach pain
  • chills
  • cough
  • fast, irregular, pounding, or racing heartbeat or pulse
  • fever
  • headache
  • muscle aches
  • pale skin
  • right upper abdominal or stomach pain and fullness
  • sore throat
  • stuffy or runny nose
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Less common

  • Accumulation of pus
  • acid or sour stomach
  • belching
  • black, tarry stools
  • bladder pain
  • blood in the urine
  • bloody or cloudy urine
  • body aches or pain
  • change in hearing
  • chest pain
  • cloudy urine
  • convulsions
  • cough producing mucus
  • decreased urine
  • diarrhea
  • difficult, burning, or painful urination
  • difficulty with breathing
  • difficulty with swallowing
  • dizziness
  • dry mouth
  • ear congestion
  • ear drainage
  • earache or pain in the ear
  • frequent urge to urinate
  • general feeling of discomfort or illness
  • heartburn
  • increased thirst
  • indigestion
  • joint pain
  • loss of appetite
  • loss of voice
  • lower back or side pain
  • mood changes
  • muscle pain or cramps
  • nasal congestion
  • nausea or vomiting
  • noisy breathing
  • numbness or tingling in the hands, feet, or lips
  • red rash with watery, yellow-colored, or pus filled blisters
  • shivering
  • sneezing
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach discomfort, upset, or pain
  • sweating
  • swollen glands
  • swollen, red, tender area of infection
  • thick yellow to honey-colored crusts
  • tightness in the chest
  • troubled sleeping

Incidence not known

  • Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

Side effects not requiring immediate medical attention

Some side effects of artemether / lumefantrine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Difficulty with moving
  • lack or loss of strength
  • muscle aching or cramping
  • muscle pain or stiffness
  • weight loss

Less common

  • Back pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • burning, dry, or itching eyes
  • continuing ringing or buzzing or other unexplained noise in the ears
  • difficulty having a bowel movement (stool)
  • discharge or excessive tearing
  • dizziness or lightheadedness
  • feeling of constant movement of self or surroundings
  • hearing loss
  • hives or welts
  • redness of the skin
  • redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
  • sensation of spinning
  • shakiness and unsteady walk
  • shakiness in the legs, arms, hands, or feet
  • trembling or shaking of the hands or feet
  • uncontrolled eye movements
  • unsteadiness, trembling, or other problems with muscle control or coordination

For Healthcare Professionals

Applies to artemether / lumefantrine: oral tablet


The most frequently reported side effects included headache, anorexia, dizziness, and asthenia during clinical studies. Most side effects were mild, did not lead to artemether-lumefantrine discontinuation, and resolved. The artemether-lumefantrine 6-dose regimen was discontinued in 0.2% of adult patients due to side effects.[Ref]

Nervous system

Nervous system side effects have included headache, dizziness, and vertigo (3% or more). Tinnitus, ataxia, clonus, fine motor delay, hyperreflexia, hypoesthesia, nystagmus, and tremor have been reported in less than 3% of patients. Ototoxicity (including decreased hearing) and paresthesia have been reported.[Ref]


Gastrointestinal side effects have included anorexia, nausea, vomiting, abdominal pain, and diarrhea (3% or more). Constipation, dyspepsia, dysphagia, and peptic ulcer have been reported in less than 3% of patients.[Ref]


Other side effects have included asthenia, pyrexia, chills, fatigue, and malaise (3% or more).[Ref]


Cardiovascular side effects have included palpitations (3% or more) and QT interval prolongation.[Ref]


Hypersensitivity side effects have included hypersensitivity reactions. Hypersensitivity including urticaria and angioedema has been reported during postmarketing experience.[Ref]


Hematologic side effects have included splenomegaly and anemia (3% or more). Eosinophilia, abnormal lymphocyte morphology, decreased hematocrit, increased and decreased platelet count, increased and decreased white blood cell count have been reported in less than 3% of patients. Hemolytic anemia (including at least one case of autoimmune hemolytic anemia attributed to lumefantrine) has been reported.[Ref]


Hepatic side effects have included hepatomegaly (3% or more). Increased alanine aminotransferase and aspartate aminotransferase have been reported in less than 3% of patients. Jaundice has been reported.[Ref]

During a study, jaundice was observed in 3 patients following artemether-lumefantrine treatment; however, each patient had elevated serum bilirubin at baseline. Resolution occurred on follow-up.[Ref]


Dermatologic side effects have included pruritus and rash (3% or more). Urticaria has been reported in less than 3% of patients. Serious skin reactions (bullous eruption) have been reported rarely during postmarketing experience.[Ref]


Immunologic side effects have included malaria and nasopharyngitis (3% or more). Abscess, acrodermatitis, bronchitis, ear infection, gastroenteritis, helminthic infection, hookworm infection, impetigo, influenza, lower respiratory tract infection, oral herpes, pneumonia, respiratory tract infection, subcutaneous abscess, upper respiratory tract infection, and urinary tract infection have been reported in less than 3% of patients.[Ref]


Metabolic side effects have included hypokalemia (less than 3%).[Ref]


Musculoskeletal side effects have included arthralgia and myalgia (3% or more). Gait disturbance and back pain have been reported in less than 3% of patients.[Ref]


Respiratory side effects have included cough (3% or more). Asthma and pharyngolaryngeal pain have been reported in less than 3% of patients.[Ref]


Genitourinary side effects have included hematuria and proteinuria (less than 3%).[Ref]


Psychiatric side effects have included sleep disorder and insomnia (3% or more). Agitation and mood swings have been reported in less than 3% of patients.[Ref]


1. "Product Information. Coartem (artemether-lumefantrine)." Novartis Pharmaceuticals, East Hanover, NJ.

2. "Artemether-lumefantrine (Coartem) for treatment of malaria." Med Lett Drugs Ther 51 (2009): 75-6

3. Lefevre G, Looareesuwan S, Treeprasertsuk S, et al. "A clinical and pharmacokinetic trial of six doses of artemether-lumefantrine for multidrug-resistant Plasmodium falciparum malaria in Thailand." Am J Trop Med Hyg 64(5-6) (2001): 247-56

4. Bakshi R, Hermeling-Fritz I, Gathmann I, Alteri E "An integrated assessment of the clinical safety of artemether-lumefantrine: a new oral fixed-dose combination antimalarial drug." Trans R Soc Trop Med Hyg 94 (2000): 419-24

5. McCall MB, Beynon AJ, Mylanus EA, van der Ven AJ, Sauerwein RW "No hearing loss associated with the use of artemether-lumefantrine to treat experimental human malaria." Trans R Soc Trop Med Hyg 100 (2006): 1098-104

6. Stover KR, King ST, Robinson J "Artemether-lumefantrine: an option for malaria." Ann Pharmacother 46 (2012): 567-77

7. Toovey S "Effects of weight, age, and time on artemether-lumefantrine associated ototoxicity and evidence of irreversibility." Travel Med Infect Dis 4 (2006): 71-6

8. Toovey S "A case-control auditory evaluation of patients treated with artemether-lumefantrine." Am J Trop Med Hyg 74 (2006): 939-40; author reply 940

9. Gurkov R, Eshetu T, Miranda IB, et al. "Ototoxicity of artemether / lumefantrine in the treatment of falciparum malaria: a randomized trial." Malar J 7 (2008): 179

10. McGready R, Tan SO, Ashley EA, et al. "A randomised controlled trial of artemether-lumefantrine versus artesunate for uncomplicated plasmodium falciparum treatment in pregnancy." PLoS Med 5 (2008): e253

11. Merat S, Lambert E, Vincenti-Rouquette I, Gidenne S, Rousseau JM, Brinquin L "Case report: combination artemether-lumefantrine and haemolytic anaemia following a malarial attack." Trans R Soc Trop Med Hyg 97 (2003): 433-4

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.