• Arteether is an anti-malarial medicine.
• It is used for the treatment of severe malaria caused by Plasmodium falciparum strains.
Arteether is used for the treatment of severe falciparum malaria active against P. falciparum strains that are resistant to chloroquine, mefloquine, halofantrine, quinine, pyrimethamine, cycloguanil and amodiaquine.
Alpha/beta arteether is also used for the treatment of uncomplicated falciparum malaria.
It is an ethyl ether derivative of artemisinin, which is a natural product of the Chinese medicinal plant Artemisia annua. It is used as a second line drug in severe cases of malaria.
There are two formulations of arteether –
Alpha / beta artheether (of / arteether ) was registered in India in 1997 for use in both children and adults with severe malaria.
Artemotil, previously known as beta arteether was registered in Netherlands in 2000. There is a restriction on this drug for children lesser than 16 years due to a possible effect on the heart.
Artemotil is contraindicated in
• Pregnant females below 16 years
• Known hypersensitivity to artemotil and/or sesame oil
• Treatment of uncomplicated falciparum malaria
• Treatment of vivax malaria
• Artemotil is available as an injectable formulation in color coded ampoules containing either 150mg or 50mg artemotil respectively dissolved in 1 ml sesame oil. The latter is recommended for use in children weighing <16 kilogram body weight.
• Alpha and beta Arteether is also available as an injectable formulation in ampoules containing either 150 mg dissolved in 2 ml. arachis oil or 80 mg dissolved in 1 ml arachis oil. No specific pediatric formulation exists.
Alpha/beta Arteether in Adults:
• Intramuscular injection of one ampoule, containing 150mg / arteether, daily for 3 consecutive days (i.e. total dose 480 mg irrespective of body weight or 3mg/kg/day for a 50kg adult).
• Intramuscular injection of 3mg / arteether/kg body weight daily for 3 consecutive days.
Artemotil (children and adolescents up to the age of 16 years only):
• Intramuscular injection of 4.8mg/kg body weight as a loading dose followed by 1.6mg/kg body weight administered 6, 24, 48 and 72 hours after the loading dose.
• The injection can alternatively be continued on further consecutive days until the patient can take oral therapy with another effective antimalarial drug.
• Use of artemotil is restricted to children and adolescents under the age of 16 because of the possibility that it may have an effect on the heart.
• Product must be used only via the intramuscular route.
• The loading dose should be equally divided and injected anteriorly into both thighs with each subsequent dose injected into alternating thighs.
• The use of artemotil for the treatment of severe malaria in patients with pre-existing renal or liver failure has not been studied.
• Use caution when using arteether in the case of medicine induced fever, patients with heart disease and drug resistance.
Possible side effects include
• Cardiac effects such as bradycardia and QT interval prolongation.
• Neurotoxicity has been shown in animal studies
• Pain at the injection site. This can be overcome by administering repeated injections in alternate thighs.
Regimens that include only artemisinin or its derivatives should not be used for less than 7 days because of the unacceptable high levels of remissions or relapses of the condition. Hence, it is recommended that artemisinin derivatives be given for a minimum of 3 days until the patient can take oral therapy of an effective antimalarial to complete 7 days of therapy.
Important Precautions are listed below:
• Consult your doctor immediately if your symptoms do not improve, you are unable to eat, or you develop fainting.
• Do not drive or operate machinery
• Do not stop medication
• Finish the entire course of treatment as prescribed
• Inform your doctor if you have existing medical problems including heart problems or HIV
• Inform your doctor of all your other medications
• Monitor blood test once a week
• Take with food
• This medication is only indicated for cases where resistance to quinine is growing
• Arteether should not be used with drugs that strongly inhibit the cytochrome P450 enzyme CYP3A4 like HIV protease inhibitors or ketoconazole or those that strongly induce the the CYP3A4 enzyme like carbamazepine and phenobarbital.
• Artheeter interacts severely with quetiapine and moderately with mefloquine.
• Arteether should be stored at room temperatures of 25C.
• Keep it out from the reach of children.
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