Artequin Dose, Combination, Side Effect, Use

Artequin is a free combination of two types of tablets which contain the active ingredients called artesunate and mefloquine, respectively. Each pack contains 3 tablets with artesunate and 3 tablets with mefloquine. Artequin belongs to the group of medicines known as antimalarials, i.e., drugs used to treat malaria infection.

Artequin

It works by killing the malaria parasites (small organisms called Plasmodium, which consist of a single cell, and which are found inside the red blood cells). The treatment course of a malaria infection with Artequin lasts for 3 days, during which all tablets contained in the pack have to be taken following a certain administration schedule.

Artequin is used to treat partially immune patients who present an acute uncomplicated malaria infection caused by Plasmodium falciparum (a particular type of malaria parasite) occurring in endemic areas.

Artequin can also be used in multi-drug resistant areas where resistance is developing to current therapies of P. falciparum infections. Artequin is a product of Alcino, in Switzerland.

Composition Of Artequin

Composition Of Artequin-300/375

Each pack of Artequin-300/375 is composed of:

-3 film-coated tablets containing each 100 mg of the active substance artesunate.

The other ingredients are:

Tablet core: microcrystalline cellulose, lactose monohydrate, sodium croscarmellose, hypromellose, talc, magnesium stearate (vegetable), maize starch, anhydrous colloidal silica.

Coating: hypromellose, titanium dioxide (E171), macrogol 6000.

-3 film-coated tablets containing each 125 mg of the active substance mefloquine (as 137.5 mg mefloquine hydrochloride).

The other ingredients are:

Tablet core: sodium lauryl sulfate, sodium croscarmellose, microcrystalline cellulose, lactose monohydrate, colloidal silicon dioxide, hypromellose, pregelatinized starch, macrogol 6000, magnesium stearate (vegetable).

Coating: talc, titanium dioxide (E171), hypromellose, macrogol 6000.

Composition Of Artequin-600/750

Each pack of Artequin-600/750 is composed of:

-3 film-coated tablets containing each 200 mg of the active substance artesunate.

The other ingredients are:

Tablet core: microcrystalline cellulose, lactose monohydrate, sodium croscarmellose, hypromellose, talc, magnesium stearate (vegetable), maize starch, anhydrous colloidal silica.

Coating: hypromellose, titanium dioxide (E171), macrogol 6000.

-3 film-coated tablets containing each 250 mg of the active substance mefloquine (as 273 mg mefloquine hydrochloride).

The other ingredients are:

Coating: talc, titanium dioxide (E171), hypromellose, macrogol 6000.

What Should Be Observed When Taking Artequin?

Plasmodium falciparum malaria is a serious, life-threatening disease that requires complete cure. To achieve this, it is extremely important to take all tablets of one pack of Artequin exactly as prescribed by the doctor and for the full 3-day course of treatment, even if you begin to feel better after some time. If you do not take both sorts of tablets each day or if you stop taking this medicine too early i.e before you have taken the last dose on the third day), you may not recover completely.

Read Also: How to test for malaria at home

When Must Artequin Not Be Taken?

You must not use Artequin if you

- are allergic to artesunate, mefloquine, other related compounds such as artemisinin derivatives, quinine, quinidine or chloroquine, or to any of the other ingredients of Artequin.

- take halofantrine (another antimalarial drug).

- take Hypericum extract (extracts of St John's wort).

Artequin is not appropriate for prophylactic use against malaria infections.

When Is Caution Needed While Taking Artequin?

Inform your pharmacist or medical doctor if you suffer from any disease or have any allergies.

The intake of mefloquine, one of the active substances of Artequin, may cause psychiatric symptoms, e.g., anxiety, paranoia, depression, hallucinations and psychotic behavior. Occasionally, these symptoms can last for a while after the intake of mefloquine has been stopped.

In rare cases, suicidal thoughts and suicide have been reported, but it could not be confirmed that these were due to the intake of mefloquine. If you suffer from active depression or have suffered from depression, anxiety, psychosis, or schizophrenia or other major psychiatric disorders in the past, you should inform your doctor about this.

Mefloquine may increase the risk of convulsions in epileptic patients and inform your doctor in case of such a condition.

Dizziness, drowsiness or disturbed sense of balance has been reported during the use and up to several months after the last intake of mefloquine in small numbers of patients. Therefore, if you receive Artequin, caution is advised when driving vehicles, piloting aircraft, operating machinery, deep sea diving or pursuing other activities requiring full attention and fine-motor coordination.

Please tell your pharmacist or medical doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. If mefloquine is taken together with other related compounds (e.g. quinine, quinidine and chloroquine), the risk of convulsions may be increased. Halofantrine (another antimalarial drug) must not be taken together with Artequin and or during the 15 weeks after the last dose of Artequin has been taken.

Maximum precautions should be taken when mefloquine is administered together with anticonvulsive drugs, e.g. valproic acid, carbamazepine, phenobarbital or phenytoin because Artequin may reduce their absorption, thus resulting in seizures.

Ketoconazole (an antifungal medicine) should not be taken during Artequin therapy, or within 15 weeks after the last dose of Artequin has been taken.

Concomitant administration of Artequin and ritonavir (a medicine used to treat HIV infection) should be avoided.

Due to the interaction of Artequinwith Hypericum extract, and thus the possible loss of potency of Artequin, Artequin must not be simultaneously taken with preparations containing Hypericum extract (extracts of St. John's wort).

This phenomenon can also occur with concomitant treatment of rifampicin (an antibiotic medicine) and Artequin. Simultaneous therapy with rifampicin and Artequin should be limited to emergencies.

This medicine contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

May Artequin Be Taken During Pregnancy Or When Breast-feeding?

Ask your pharmacist or medical doctor for advice before taking any medicine. Since experience in pregnancy is limited, you should not take Artequin while pregnant unless explicitly authorized by your doctor. It is important to tell your doctor if you are pregnant or think you could be pregnant, as he or she may decide that you should not use this medicine.

It is recommended that you do not breast-feed while you are taking Artequin.

How Is Artequin Use?

How Is Artequin-300/375 Used?

Always take Artequin-300/375 exactly as your doctor has told you. You should check with your pharmacist or medical doctor if you are not sure.

Read Also: Best malaria drugs in Nigeria

Partially immune patients with a body weight between 15 and 30 kg: Treatment consists of 3 daily doses of two film-coated tablets i.e., one artesunate 100 mg film-coated tablet and one mefloquine 125 mg film-coated tablet, taken together as a single daily dose, for three consecutive days.

The 2 film-coated tablets which constitute the daily dose of Artequin-300/375, must be taken at the same time (simultaneously), without chewing them, with plenty of water and a meal, if possible.

If it is too difficult for you to swallow the tablets, they may be crushed and dissolved in some water.

The first Artequin-300/375 dose of 2 tablets should be taken immediately after the initial diagnosis of your malaria infection (day 1), followed by a second two-tablet dose 24 hours thereafter (day 2) and a third (last) dose of 2 tablets 48 hours after the first dose has been taken (day 3).

The tablets are organized in the package in a way that you can easily see which tablets to take on which day: each day has its own color (day 1 = red, day 2=blue; day 3=green).

Make sure that you do not miss a daily dose (2 film-coated tablets). However, if you forgot a daily dose of Artequin-300/375 and 600/750, take the forgotten dose (2 tablets) as soon as you realize that you forgot to take it. Then take the next dose (2 tablets) after a further 24 hours interval.

If you cannot take the full treatment course (e. g. because of vomiting), you have to consult your doctor.

How Is Artequin-600/750 Use?

Always take Artequin-600/750 exactly as your doctor has told you. You should check with your pharmacist or medical doctor if you are not sure.

Partially immune patients with a body weight above 30 kg: Treatment consists of 3 daily doses of two film-coated tablets i.e., one artesunate 200 mg film-coated tablet and one mefloquine 250 mg film-coated tablet, taken together as a single daily dose, for three consecutive days.

The 2 film-coated tablets which constitute the daily dose of Artequin-600/750 must be taken at the same time (simultaneously), without chewing them, with plenty of water and a meal, if possible.

Read Also: How to treat malaria in children

If it is too difficult for you to swallow the tablets, they may be crushed and dissolved in some water.

The first Artequin-600/750 dose of 2 tablets should be taken immediately after the initial diagnosis of your malaria infection (day 1), followed by a second two-tablet dose 24 hours thereafter (day 2) and a third (last) dose of 2 tablets 48 hours after the first dose has been taken (day 3).

The tablets are organized in the package in a way that you can easily see which tablets to take on which day: each day has its own color (day 1 = red, day 2=blue; day 3=green).

Make sure that you do not miss a daily dose (2 film-coated tablets). However, if you forgot a daily dose of Artequin-600/750, take the forgotten dose (2 tablets) as soon as you realize that you forgot to take it. Then take the next dose (2 tablets) after a further 24 hours interval.

If you cannot take the full treatment course (e. g. because of vomiting), you have to consult your doctor.

Patients With Less Than 15 Kg Body Weight

For malaria treatment in patients weighing below 15 kg, the concentration of active substances in Artequin-300/375 and 600/750 is too high. A pediatric Artequin preparation (with the combination of artesunate and mefloquine) is recommended.

What Are The Possible Side Effects Of Artequin?

Like all medicines, Artequin may cause side effects, although not everybody gets them.

Since many of these symptoms also accompany a malarial infection, it may be difficult to distinguish whether these are malaria symptoms or side effects of Artequin.

In the following cases the therapy with Artequin must immediately be discontinued and a doctor consulted:

- if sudden anxiety states, depression, restlessness, epileptic attacks or mental confusion develop.

- if other symptoms (e.g. skin rashes) occur.

The following side effects may occur with the intake of Artequin:

Common Side Effects

These are likely to affect between 1 and 10 in every 100 people.

- abdominal pain

- nausea

- vomiting

- diarrhoea

- loss of appetite

- dizziness

- headache

- sleeplessness

- rash

- itching

- fatigue and general weakness

- hypokalaemia (low potassium concentration in the blood)

Rare Side Effects

These are likely to affect between 1 and 10 in every 10,000 people.

- mild and transient reduction in certain types of blood cells.

- increase of some blood values.

Nevertheless, any other side effects which have been reported with the intake of mefloquine as monotherapy, may occur also with intake of Artequin.

Read Also: Treatment of malaria

Described mefloquine side effects are: Nausea, vomiting, loss of appetite, eating disorders, soft stools or diarrhea, abdominal pain, dizziness, impaired balance, headache, fatigue, sleep disturbances, vivid dreams, lightheadedness, liver disorders, disorders of blood formation. In rarer cases cardiovascular disorders (too high or too low blood pressure), skin reddening, fainting, palpitations, irregular or slow pulse, chest pain, itching or skin rashes, loss of hair, water retention in tissue, muscle pains, muscle weakness, muscle cramps, joint pains, breathlessness, sweating, digestive disorders, visual disturbances, hearing disturbances, ringing in the ear, weakness, malaise, tiredness, fever, chills, coordination disturbances, impaired nerve sensation, shaking, convulsions, physical restlessness and psychiatric disturbances such as lassitude, depression, forgetfulness, hallucinations, aggression, panic attacks, confusion, restlessness, mood changes and anxiety states may occur.

Rare cases of suicidal thoughts and suicide have been reported. However a link with administration of the drug could not be proven.

In case of symptoms like malaise, fever, headache, nausea, weight loss and fatigue, you should inform your doctor. Remember that adverse effects can occur or persist for several weeks after the last dose of Artequin has been taken.

Tell your doctor if you experience any of these side effects. If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your pharmacist or medical doctor.

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