Side Effects of artemether and lumefantrine: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Major research findings

Artemether-lumefantrine is a widely used combination therapy for treating malaria, especially in Africa, and is particularly important for treating uncomplicated falciparum malaria. 23 . While generally considered safe and effective, side effects are reported, including vomiting, especially in the first two days of treatment. 7 . In some cases, more serious adverse events have been noted, such as hemolytic anemia or post-malaria neurological syndrome. 6 . There is also concern about the safety of the drug during pregnancy, especially in the first trimester. 2

Reasons for side effects

While the exact reasons for side effects are not fully understood, it is believed that artemether, while effective at killing parasites, can also affect red blood cells, potentially contributing to hemolytic anemia. 6 . Lumefantrine, when metabolized by the liver, could produce substances that have adverse effects on the body. 25

Common side effects

Vomiting

Vomiting is a common side effect of artemether-lumefantrine, especially in the first two days of treatment. 7

Hemolytic anemia

Hemolytic anemia, a condition where red blood cells are destroyed faster than the body can replace them, is a serious but less common side effect. 6

Post-malaria neurological syndrome

This syndrome, characterized by neurological symptoms that persist after malaria treatment, can occur in some cases. 6

Side effect countermeasures

Vomiting

Eating before taking the medication or having small meals after taking it can help reduce vomiting. 25 . If vomiting persists, it is important to consult a doctor.

Hemolytic anemia

If you experience symptoms of hemolytic anemia, such as fatigue, shortness of breath, or paleness, seek immediate medical attention.

Post-malaria neurological syndrome

If you experience neurological symptoms after completing malaria treatment, it is important to consult a doctor to receive proper diagnosis and management.

Comparison between studies

Common points of research

Most studies agree that artemether-lumefantrine is effective for treating uncomplicated falciparum malaria. 23 7 13 The studies also generally indicate that the medication is well-tolerated, with vomiting being a common side effect. 7 13

Differences in research

While the majority of studies indicate good tolerance, some studies report more severe side effects like hemolytic anemia or post-malaria neurological syndrome, highlighting the importance of careful monitoring. 6

Notes on application to real life

Artemether-lumefantrine remains a valuable treatment option for malaria, but it is important to be aware of potential side effects. Always follow your doctor's instructions and seek immediate medical attention if you experience any concerning symptoms.

Limitations of current research

More research is needed to fully understand the long-term safety of artemether-lumefantrine, particularly regarding its effects on pregnant women and children. 2

Future research directions

Further investigation is necessary to determine long-term safety and efficacy, especially in vulnerable populations like pregnant women and children, and to explore ways to minimize side effects. 2

Conclusion

While artemether-lumefantrine remains a valuable tool for treating malaria, it is crucial to be aware of potential side effects and to follow medical guidance carefully. Continued research is vital to fully understand the drug's long-term impact and to develop strategies for safer and more effective use.

Literature analysis of 26 papers
Positive Content
24
Neutral Content
0
Negative Content
2
Article Type
7
1
2
6
24
2.

A systematic review of the safety and efficacy of artemether-lumefantrine against uncomplicated Plasmodium falciparum malaria during pregnancy.

Author: ManyandoChristine, KayentaoKassoum, D'AlessandroUmberto, OkaforHenrietta U, JumaElizabeth, HamedKamal

Improved tolerability
Malaria treatment

The World Health Organization (WHO) recommends artemisinin-based combination therapy (ACT) to treat uncomplicated falciparum malaria during the second and third trimesters of pregnancy.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

5.

Knowledge and malaria treatment practices using artemisinin combination therapy (ACT) in Malawi: survey of health professionals.

Author: Kalilani-PhiriLinda V, LunguDouglas, CoghlanRenia

Optimize ACT
Resistance to SP

In Malawi, the Ministry of Health changed the malaria treatment policy to use artemisinin-based combination therapy (ACT). It is important to assess the knowledge and practices of medical practitioners on the use of ACT to optimize its use and protect against the development of parasite resistance.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Artemisinin-based combination therapies and their introduction in Japan.

Author: KanoShigeyuki

Fewer adverse effects
Malaria treatment
Rapid parasite clearance
Hemolytic anemia
Postmalaria neurological syndrome

Artemisinin-based combination therapies (ACTs) are the recommended first-line treatment for malaria. ACTs are effective against all types of malaria, have fewer side effects than other treatments, and can quickly clear parasites from the blood.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

[Efficacy of therapeutic combinations with artemisinin derivatives in the treatment of non complicated malaria in Burundi].

Author: NdayiragijeAthanase, NiyungekoDéo, KarenzoJeanne, NiyungekoErnest, BarutwanayoMarianne, CizaAlphonse, BosmanAndrea, Moyou-SomoRoger, NahimanaAdélaïde, NyarushatsiJean Paul, BarihutaTharcisse, MizeroLiévin, NdaruhutseJérome, DelacolletteCharles, RingwaldPascal, KamanaJean

Uncomplicated falciparum malaria treatment
Vomiting

The efficacy of two artemisinin-based combination therapies, artemether-lumefantrine and amodiaquine + artesunate, was studied in children with uncomplicated falciparum malaria.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : French

8.

Effectiveness of five artemisinin combination regimens with or without primaquine in uncomplicated falciparum malaria: an open-label randomised trial.

Author: SmithuisFrank, KyawMoe Kyaw, PheOhn, WinThein, AungPyay Phyo, OoAung Pyay Phyo, NaingArkar Linn, NyoMya Yee, MyintNaing Zaw Htun, ImwongMallika, AshleyElizabeth, LeeSue J, WhiteNicholas J

Effective treatment of falciparum malaria

Artemisinin-combination therapy (ACT) is recommended for the treatment of falciparum malaria. The addition of a single gametocytocidal dose of primaquine is being investigated.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Exploring provider and community responses to the new malaria diagnostic and treatment regime in Solomon Islands.

Author: WijesingheRushika S, AtkinsonJo-An M, BobogareAlbino, WiniLyndes, WhittakerMaxine

Malaria treatment
Drug resistance

Artemisinin-based combination therapy (ACT) is the first-line treatment for malaria in many countries. This abstract examines the factors influencing community and provider acceptance of and adherence to the new treatment regime in Solomon Islands, which adopted ACT in 2009.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Amodiaquine-artesunate vs artemether-lumefantrine for uncomplicated malaria in Ghanaian children: a randomized efficacy and safety trial with one year follow-up.

Author: AdjeiGeorge O, KurtzhalsJorgen A L, RodriguesOnike P, AlifrangisMichael, HoegbergLotte C G, KitcherEmmanuel D, BadoeEbenezer V, LampteyRoberta, GokaBamenla Q

Malaria treatment

Artesunate-amodiaquine and artemether-lumefantrine, artemisinin combination therapies (ACTs) for malaria, have shown efficacy in the short term. However, there is limited information on their long-term efficacy and safety for repeated treatments, requiring further research.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Safety Profile of Artemether-Lumefantrine: A Cohort Event Monitoring Study in Public Health Facilities in Tanzania.

Author: MssusaAlambo K, FimboAdam M, NkayambaAlex F, IrundeHenry F, SilloHiiti B, ShewiyoDanstan H, HillGeraldine, MinziOmary M

Safe treatment

This study assessed the safety of artemether-lumefantrine (AL) in treating uncomplicated Plasmodium falciparum malaria in Tanzania using Cohort Event Monitoring (CEM).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

The efficacies of artesunate-sulfadoxine-pyrimethamine and artemether-lumefantrine in the treatment of uncomplicated, Plasmodium falciparum malaria, in an area of low transmission in central Sudan.

Author: MohamedA O, EltaibE H, AhmedO A, ElaminS B, MalikE M

Treats Malaria

Artesunate-sulfadoxine-pyrimethamine (ASP) and artemether-lumefantrine (AL) were equally effective and safe in treating uncomplicated malaria in central Sudan.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Early variations in plasmodium falciparum dynamics in Nigerian children after treatment with two artemisinin-based combinations: implications on delayed parasite clearance.

Author: MichaelObaro S, GbotoshoGrace O, FolarinOnikepe A, OkuboyejoTitilope, SowunmiAkintunde, OduolaAyoade M J, HappiChristian T

Treat malaria

Combination treatments, preferably containing an artemisinin derivative, are recommended for malaria. This study protocol was designed to evaluate the early effects of artemether-lumefantrine and artesunate-amodiaquine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Malaria prevention in the pregnant traveller: a review.

Author: RoggelinLouise, CramerJakob P

Malaria prevention
Travel safety
Anti-malarial safety
First trimester risks

Malaria is a serious health concern, particularly for infants and pregnant women in tropical areas. This review examines the current evidence for malaria prevention in pregnant travelers, analyzing the risks and benefits of both anti-mosquito measures and antimalarial drugs during pregnancy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

A randomized trial of artesunate-sulfamethoxypyrazine-pyrimethamine versus artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in Mali.

Author: SagaraIssaka, DickoAlassane, DjimdeAbdoulaye, GuindoOusmane, KoneMamady, ToloYoussouf, TheraMahamadou A, SogobaMoussa, FofanaMoussa, OuattaraAmed, SissokoMady, JansenHerwig F, DoumboOgobara K

Infection prevention
Malaria treatment

Artesunate-sulfamethoxypyrazine-pyrimethamine was more effective in treating uncomplicated P. falciparum malaria than artemether-lumefantrine, with a cure rate of 98.7% versus 89.6%. The drug was well-tolerated and showed an additional benefit of preventing new infections.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Efficacy and safety of artemether-lumefantrine for the treatment of uncomplicated malaria in the setting of three different chemopreventive regimens.

Author: KapisiJames, BigiraVictor, ClarkTamara, KinaraStephen, MwangwaFlorence, AchanJane, KamyaMoses, SoremekunSeyi, DorseyGrant

Malaria prevention

Malaria remains a significant burden for children in Africa despite the use of insecticide-treated bed nets (ITNs). Chemoprevention has potential to reduce malaria burden; however, data on the efficacy and safety of anti-malarial therapy in the context of chemoprevention is limited.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

18.

Drug-Drug-Induced Akathisia: Two Case Reports.

Author: Owusu AboagyeGrace, AnkrahDaniel

Akathisia treatment

Drug-drug interactions between psychotropic medications and antimicrobials can lead to akathisia, an extrapyramidal side effect. This report highlights the importance of considering drug interactions as a potential cause of extrapyramidal side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

19.

Efficacy and Safety of Artemisinin-Piperaquine for the Treatment of Uncomplicated Malaria: A Systematic Review.

Author: WangQi, ZouYuanyuan, PanZiyi, ZhangHongying, DengChangsheng, YuanYueming, GuoJiawen, TangYexiao, JulieNadia, WuWanting, LiGuoming, LiMingqiang, TanRuixiang, HuangXinan, GuoWenfeng, LiChangqing, XuQin, SongJianping

Malaria treatment

This systematic review and meta-analysis evaluated the efficacy and safety of artemisinin-piperaquine (AP) in the treatment of uncomplicated malaria. The study found that AP is a safe and effective treatment for uncomplicated malaria.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

20.

Randomized non-inferiority and safety trial of dihydroartemisin-piperaquine and artesunate-amodiaquine versus artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Cameroonian children.

Author: NjiAkindeh M, AliInnocent M, MoyehMarcel N, NgongangEric-Oliver, EkolloAristide M, ChedjouJean-Paul, NdikumValentine N, EveheMarie S, FroeschlGuenter, HeumannChristian, MansmannUlrich, OgundahunsiOlumide, MbachamWilfred F

Malaria treatment

This study compared the clinical efficacy, tolerability, and safety of three antimalarial drugs (ASAQ, AL, and DHAP) in children under 10 years old.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Efficacy and safety of the six-dose regimen of artemether-lumefantrine in pediatrics with uncomplicated Plasmodium falciparum malaria: a pooled analysis of individual patient data.

Author: MakangaMichael, PremjiZul, FaladeCatherine, KarbwangJuntra, MuellerEdgar A, AndrianoKim, HuntPhilip, De PalaciosPatricia Ibarra

Uncomplicated P. falciparum malaria treatment

The six-dose regimen of artemether-lumefantrine (Coartem) is safe and more effective than the four-dose regimen for treating uncomplicated P. falciparum malaria in children.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Case Report: Could Artemisinin-Based Combination Therapy Prevent Occupational Malaria following Blood Exposure?

Author: MinardGeoffrey, ToucheSylvie, DelavelleAnne-Catherine, BonnetMorgane, HugueninAntoine, N'GuyenYohan

Malaria prevention

This case report suggests that artemisinin-based combination therapy (ACT) can prevent occupational Plasmodium falciparum malaria after a needle-stick injury.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Artemisinin-based combination therapies and their introduction in Japan.

Author: KanoShigeyuki

Faster clearance
Malaria treatment
Hemolytic anemia
Neurological syndrome

This abstract advocates for the introduction of artemisinin-based combination therapies (ACTs) in Japan for the treatment of imported malaria cases due to the increasing number of cases and the potential for severe complications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

Increased systemic exposures of artemether and dihydroartemisinin in infants under 5 kg with uncomplicated Plasmodium falciparum malaria treated with artemether-lumefantrine (Coartem®).

Author: TionoAlfred B, TintoHalidou, AlaoMaroufou J, MeremikwuMartin, TshefuAntoinette, OgutuBernhards, OuedraogoAlphonse, LinganiMoussa, CousinMarc, LefèvreGilbert, JainJay Prakash, DuparcStephan, HamedKamal

Malaria treatment
Well tolerated
Neurotoxicity

A 3-day regimen of artemether-lumefantrine (AL) dispersible formulation was effective and well-tolerated in infants under 5 kg with uncomplicated Plasmodium falciparum malaria. However, artemether and dihydroartemisinin exposure levels were two- to three-fold greater than historical values in infants and children 5 kg and above, which is not supported by preclinical safety margins for neurotoxicity. Dosing recommendations for infants under 5 kg cannot be made as the potential for toxicity is unknown.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

26.

Monitoring of efficacy and safety of artemisinin-based anti-malarials for treatment of uncomplicated malaria: a review of evidence of implementation of anti-malarial therapeutic efficacy trials in Tanzania.

Author: ShayoAlex, BuzaJoram, IshengomaDeus S

malaria treatment
parasite resistance

The study assessed the implementation of anti-malarial efficacy testing for monitoring the therapeutic efficacy of ACT for treatment of uncomplicated malaria in Tanzania before and after policy changes in 2006.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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