Lumartem Dosage

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QUESTION

What is the dosage for a toddler who is taking Lumartem tablet?

ANSWER

Lumartem, like many anti-malarial drugs, is dosed by weight. Therefore if your toddler weights 5-15kg, s/he should be give one tablet (containing 20mg of artemether and 120mg of lumefantrine) immediately after diagnosis of malaria, then another tablet 8 hours after the first one, then one tablet every 12 hours after that until the end of the 3rd day (a total of 6 tablets, taken over 6 doses).

For children weighing 15-25kg, the timing of the doses is the same, but each time, give two tablets. Try not to miss a dose, but if you do, give the child the missed dose as soon as you remember, then wait the prescribed time interval (12 hours, usually) before giving the next one. Do not give a double dose.

Treatment Duration of Lumartem

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QUESTION

I am on the lumartem treatment. I started at 8am to 4 pm. then 4am. i forgot to take the drugs at 4pm, but took it at 8;30o. Should I start all over or continue at 4am or 8 am?

ANSWER

If you miss a tablet, you should take the next one as soon as you remember, then wait the required interval before taking the pill after that. So, since you took the missed pill at 8.30, you should take the following one at 8.30am (12 hours later). Then continue as you would normally until all 6 doses have been taken – it is very important to complete the full course of tablets.

G6PD and Malaria

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QUESTION:

Does one need to have a normal result in G6PD screening before he can take Malarial pills?

ANSWER:

In some cases, yes. When a patient has been diagnosed with Plasmodium ovale or Plasmodium vivax infection, in addition to medication such as chloroquine to target the blood stages of the parasite, an additional drug, called primaquine, may also be required. Primaquine kills the liver stages, known as hypnozoites, of these forms of malaria, preventing relapse of infection later on.

However, primaquine is known to cause severe haemolytic anaemia in people who are G6PD deficient. G6PD deficiency is restricted to certain populations or segments of populations; therefore it may be that not every person requiring primaquine will be tested for their G6PD status, only those considered high risk for potential deficiency. Patients with severe G6PD deficiency should not take primaquine; unfortunately at this stage there are no alternative drug regimens available. Patients with mild forms of G6PD deficiency should take primaquine at an alternative dose to G6PD-normal patients, usually 0.75mg/kg bodyweight once a week for 8 weeks (as opposed to 0.25mg/kg bodyweight once a day for 5 or 14 days, depending on the case history of the patient and the physician’s recommendation).

There is also some evidence that quinine can cause haemolysis in patients with G6PD deficiency; such patients may also have increased blood concentrations of mefloquine when taken concurrently with primaquine. As such, combinations of quinine or mefloquine with primaquine in G6PD-deficient patients is not recommended.