The Basics
What is Artemether and Lumefantrine?
Used to treat acute, uncomplicated malaria, and in malaria infections in areas or regions where it is known that other medicines (eg, chloroquine) may not work.
Brand names for Artemether and Lumefantrine
Coartem
How Artemether and Lumefantrine is classified
Anti-Infective Agents, Antiparasitic Agents, Antimalarials, Antiprotozoal Agents
Artemether and Lumefantrine During Pregnancy
Artemether and Lumefantrine pregnancy category
Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Artemether and Lumefantrine while pregnant
Published data from clinical studies and pharmacovigilance data have not established an association with artemether/lumefantrine use during pregnancy and major birth defects, miscarriage, or adverse maternal or fetal outcomes (see Data). The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.
Taking Artemether and Lumefantrine While Breastfeeding
What are recommendations for lactation if you're taking Artemether and Lumefantrine?
Artemether and lumefantrine have not been studied in nursing mothers. Estimates of its excretion into breastmilk indicate that amounts in milk are very low. The Centers for Disease Control and Prevention consider the drug combination acceptable for use in mothers nursing an infant weighing at least 5 kg (11 pounds) and it can be given directly to infants weighing 5 kg or more.[1] The safety of the combination in breastfed infants under 5 kg is not known.
Maternal / infant drug levels
Artemether and lumefantrine have not been studied in nursing mothers. Estimates of its excretion into breastmilk indicate that amounts in milk are very low. The Centers for Disease Control and Prevention consider the drug combination acceptable for use in mothers nursing an infant weighing at least 5 kg (11 pounds) and it can be given directly to infants weighing 5 kg or more.[1] The safety of the combination in breastfed infants under 5 kg is not known.
Possible effects of Artemether and Lumefantrine on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Artemether and Lumefantrine
Atovaquone and Proguanil, Chloroquine, Mefloquine,.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Centers for Disease Control and Prevention. CDC Yellow Book 2018: Health Information for International Travel. New York: Oxford University Press. 2017. https://wwwnc.cdc.gov/travel/page/2018-yellow-book-about
2. Adjei GO, Goka BQ, Binka F, Kurtzhals JA. Artemether-lumefantrine: an oral antimalarial for uncomplicated malaria in children. Expert Rev Anti Infect Ther. 2009;7:669-81. PMID: 19681693
3. Jain JP, Ganesan S, Lefevre G et al. Estimating of the amount of artemether and lumefantrine excreted through breast milk. Trop Med Int Health. 2015;20 (Suppl. S1):184-5. Abstract. DOI: doi:10.1111/tmi.12574
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
