Skip to main content

Coartem Side Effects

Generic name: artemether / lumefantrine

Medically reviewed by Last updated on Nov 28, 2022.

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

Applies to artemether / lumefantrine: oral tablet.

Serious side effects of Coartem

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

Other side effects of Coartem

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 common side effects were headache, anorexia, dizziness, asthenia, arthralgia, and myalgia during clinical studies. Most side effects were mild, did not lead to discontinuation of this drug, and resolved. The 6-dose regimen was discontinued due to side effects in 0.2% of adult patients.[Ref]

Nervous system

Very common (10% or more): Headache (up to 56%), dizziness (up to 39%)

Common (1% to 10%): Vertigo, paresthesia, clonus

Uncommon (0.1% to 1%): Somnolence, involuntary muscle contractions, hypoesthesia, ataxia

Frequency not reported: Tinnitus, fine motor delay, hyperreflexia, nystagmus, tremor, ototoxicity (including decreased hearing)[Ref]


Very common (10% or more): Anorexia (up to 40%), decreased appetite

Frequency not reported: Hypokalemia[Ref]


Very common (10% or more): Asthenia (up to 38%), pyrexia/fever (up to 25%), chills (up to 23%), fatigue (up to 17%)

Common (1% to 10%): Malaise, rigors, parasitic infestation, viral infection, abscess

Uncommon (0.1% to 1%): Abnormal gait, gait disturbance

Frequency not reported: Ear infection

Postmarketing reports: Face edema, peripheral edema[Ref]


Very common (10% or more): Arthralgia (up to 34%), myalgia (up to 32%)

Common (1% to 10%): Back pain[Ref]


Very common (10% or more): Nausea (up to 26%), vomiting (up to 17%), abdominal pain (up to 17%)

Common (1% to 10%): Diarrhea, dyspepsia

Frequency not reported: Constipation, dysphagia, peptic ulcer, gastroenteritis, helminthic infection, hookworm infection, oral herpes[Ref]


Very common (10% or more): Sleep disorder (up to 22%)

Common (1% to 10%): Insomnia

Frequency not reported: Agitation, mood swings[Ref]


Very common (10% or more): Palpitations (up to 18%)

Common (1% to 10%): QT interval prolongation on ECG

Frequency not reported: QTc prolongation (including asymptomatic)

Postmarketing reports: Hypertension[Ref]


At least 1 case of autoimmune hemolytic anemia has been attributed to lumefantrine.

Cases of delayed hemolytic anemia have been reported after treatment with this drug, primarily when used for the treatment of severe malaria in patients initially treated with IV/parenteral artesunate.[Ref]

Common (1% to 10%): Splenomegaly, anemia, malaria

Frequency not reported: Eosinophilia, abnormal lymphocyte morphology, decreased hematocrit, decreased platelet count, increased platelet count, decreased WBC count, increased WBC count, hemolytic anemia, Plasmodium falciparum infection, autoimmune hemolytic anemia

Postmarketing reports: Delayed hemolytic anemia, thrombocytopenia[Ref]


Common (1% to 10%): Hepatomegaly, increased liver function tests

Frequency not reported: Increased ALT, increased AST, hepatitis

Postmarketing reports: Jaundice[Ref]

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


Common (1% to 10%): Cough/coughing, nasopharyngitis, pharyngitis

Frequency not reported: Asthma, pharyngolaryngeal pain, bronchitis, influenza, lower respiratory tract infection, pneumonia, respiratory tract infection, upper respiratory tract infection, rhinitis[Ref]


Common (1% to 10%): Pruritus, rash

Uncommon (0.1% to 1%): Urticaria

Frequency not reported: Acrodermatitis, impetigo, subcutaneous abscess

Postmarketing reports: Serious skin reactions (bullous eruption), urticaria, angioedema, erythematous rash[Ref]


Postmarketing reports: Hypersensitivity reactions (including urticaria, angioedema), anaphylaxis[Ref]


Frequency not reported: Hematuria, proteinuria, urinary tract infection

Postmarketing reports: Chromaturia, hemoglobinuria[Ref]


Frequency not reported: Conjunctivitis[Ref]


1. "Product Information. Coartem (artemether-lumefantrine)." Novartis Pharmaceuticals (2009):

2. 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

3. 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

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

5. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

6. Cerner Multum, Inc. "Australian Product Information." O 0

7. 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

8. 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

9. 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

10. 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

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

12. 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

13. 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.