Qtc Prolonging Drugs
Contraindicated
Textbook
Increased risk of cardiac conduction abnormalities including QTc prolongation.
Artemether-lumefantrine ACT should not be given to patients receiving Q-Tc prolonging drugs.
Source: KDT 7e · p816-835
Drug reference
artemether
Sesquiterpine lactone · Antimalarial
Sesquiterpine lactoneAntimalarialATC P01BE02
CDSCO approvedATC P01BE02
EXCRETION
—
not curated
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
C
FDA category + note
Top interactionssee all 12 →
- Qtc Prolonging DrugsContraindicatedTextbookKDT 7e · p816-835
- AmprenavirSevereDatabaseDDInter
- ApalutamideSevereDatabaseDDInter
- AtazanavirSevereDatabaseDDInter
Mechanism
Artemether is an artemisinin derivative. The endoperoxide bridge in its molecule interacts with heme in the parasite, causing ferrous iron-mediated cleavage and release of highly reactive free radical species. These free radicals bind to membrane proteins, cause lipid peroxidation, damage endoplasmic reticulum, and ultimately result in lysis of the parasite. It is a potent and rapid blood schizontocide.
Indications
uncomplicated CQ-resistant falciparum malaria (as part of ACT)severe and complicated falciparum malaria (parenteral)Uncomplicated falciparum malaria (as ACT with lumefantrine, extensively used in Southeast Asia and Africa)Severe and complicated falciparum malaria (i.m., preferred over quinine)
Dosing
- Adult
- Uncomplicated CQ-resistant falciparum: 80 mg + Lumefantrine 480 mg twice daily × 3 days. Severe/complicated falciparum (IM): 3.2 mg/kg on day 1, followed by 1.6 mg/kg daily for 7 days (switch to 3-day oral ACT when possible).
Pharmacokinetics
Onset
fastest
Peak effect
short
Half-life
3–10 hours (variable)
Protein binding
Lipid-soluble, administered orally or i.m.
Metabolism
Substantial first pass metabolism, converted to DHA by CYP3A4
Side effects
Common
NauseaVomitingAbdominal painItchingDrug feveranorexiaheadachedizzinesssinus bradycardiatransient first-degree heart blockcontact dermatitis
Serious
- Headache
- Tinnitus
- Dizziness
- Bleeding
- Dark urine
- S-T segment changes
- Q-T prolongation
- First degree A-V block
- Transient reticulopenia
- Leucopenia
- neurotoxicity (ataxia, convulsions)
Pregnancy & lactation
Pregnancy
C
Lactation
Safety not yet proven in 1st trimester of pregnancy.
Drug interactions
Amprenavir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Apalutamide
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Atazanavir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Boceprevir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Carbamazepine
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Ceritinib
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Clarithromycin
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Cobicistat
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Conivaptan
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Darunavir
Severe
Database
Decreased artemether levels.
Source: DDInter
Delavirdine
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Related guidelines
Other Sesquiterpine lactone drugs
Ask House about artemether
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Harrison 22e·Verified: 2026-05-10 · House clinical team