🦟 Medication Guide

Artemisinin-based combination therapy (ACT) / Antimalarial

Coartem — Malaria Treatment

The recommended first-line treatment for uncomplicated malaria in Nigeria.

Artemether/lumefantrine (Coartem) is the WHO-recommended and Nigerian Federal Ministry of Health-approved first-line treatment for uncomplicated malaria. It is a 6-dose 3-day course that clears malaria parasites rapidly and effectively when taken correctly.

📋 Patient Information Guide. This page explains how this medication works in plain language. It does not replace your doctor's advice. Always take medication as prescribed and discuss any concerns with your doctor or pharmacist.

What It Is Used For

✓ Uncomplicated Plasmodium falciparum malaria (the main malaria species in Nigeria)

✓ Malaria caused by other Plasmodium species when other treatments are unavailable

How It Works

Artemether acts rapidly to kill malaria parasites in the blood, while lumefantrine has a longer action that clears remaining parasites. The combination prevents the parasites from developing resistance — a key advantage of ACT over older single-drug treatments like chloroquine (to which P. falciparum is now widely resistant in Nigeria).

Dosing — Typical Guidance

Adults and children over 35kg

Four tablets per dose. Doses: 0 hours, 8 hours, then every 12 hours for 2 more days. Total: 24 tablets over 3 days.

Children 15–25kg

Two tablets per dose, same schedule — total 12 tablets.

Children 25–35kg

Three tablets per dose, same schedule — total 18 tablets.

Children 5–15kg

One tablet per dose — paediatric dosing must be confirmed by weight.

Duration

All 6 doses must be completed even if feeling better after the first 1–2 doses.

🍽️ Food & Timing: MUST be taken with food or a fatty drink (milk, Milo, pap with milk). Lumefantrine is very poorly absorbed without fat — taking it without food reduces drug levels significantly and risks treatment failure.

⚠️ Important Safety Note: Coartem should NOT be used for severe or complicated malaria (high fever with altered consciousness, convulsions, or inability to take oral medication). Severe malaria requires injectable artesunate in hospital — this is a medical emergency.

Side Effects

Common

Headache, dizziness, nausea, vomiting, abdominal pain, fatigue — most are also symptoms of malaria itself and may improve as treatment works.

Usually manageable. Take with food to reduce nausea.

Common

Sleep disturbances, joint pain, loss of appetite

Usually resolve after completing the course.

Uncommon

Mild prolongation of the QT interval on ECG (heart rhythm effect)

Clinically significant only in people with existing heart rhythm problems.

Rare

Serious allergic reaction

Seek emergency care immediately if rash, swelling, or breathing difficulty occurs.

Who Should Avoid This Medication

Who Should Not Take This (or Use With Caution)

⚠️ People with severe or complicated malaria — need injectable treatment in hospital
⚠️ First trimester of pregnancy — artemisinins have potential teratogenic effects. Quinine is preferred in the first trimester. Coartem is generally considered safe from the second trimester onwards.
⚠️ People with significant heart rhythm problems
⚠️ Known allergy to artemether or lumefantrine

Drug Interactions to Know

Medication / Substance	Why It Matters
Other QT-prolonging medications	Should not be combined with halofantrine, quinidine, or some antifungals. Tell your doctor all medications you are taking.
Rifampicin (TB medication)	Significantly reduces Coartem blood levels — alternative malaria treatment needed for people on TB treatment.
Grapefruit juice	May affect drug levels — avoid during treatment.

Monitoring While on This Medication

Malaria RDT or blood film

Repeat test if symptoms do not improve within 48 hours of starting treatment — to confirm diagnosis and check for treatment failure.

Temperature

Fever should begin to improve within 24–48 hours of starting treatment.

Complete the course

All 6 doses must be completed — stopping early risks treatment failure and resistance.

Frequently Asked Questions

Can I take Coartem without testing for malaria?

Ideally, malaria should be confirmed by a test (rapid diagnostic test or blood film) before treatment. Treating without confirmation risks missing another diagnosis and contributing to antimalarial resistance.

Why can I not use chloroquine anymore?

Plasmodium falciparum — the malaria species causing most illness in Nigeria — is now widely resistant to chloroquine. ACTs like Coartem are significantly more effective.

I feel better after 2 doses — can I stop?

No. You must complete all 6 doses. Stopping early leaves parasites in the blood, causes treatment failure, and risks the development of drug-resistant malaria.

Can pregnant women take Coartem?

In the first trimester, Coartem is generally avoided and quinine + clindamycin is preferred. From the second trimester onwards, Coartem is considered safe and is the recommended treatment.

What if malaria comes back after treatment?

Recurrence within 4 weeks may indicate treatment failure or reinfection. Return to the clinic — you may need a different antimalarial. Recurrent malaria should always be confirmed by testing.

Questions about your medication?

Our doctors and pharmacists can review your prescription, explain your treatment, and address any concerns — confidentially.

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