Lokmal QS Combi Tablets: Uses, Composition, Indications, Contraindications, Dosage, Side Effects & Cost.
As the name implies, a pack of lokmal QS Combi Tablets contains both antimalarial (arthemeter and lumefantrine) and paracetamol for the fever. Lokmal is an Artemisinin-based Combination Therapies commonly called ACTs.
Composition:
Each Satchet of Lokmal QS Combi Tablets contains:
Arthemeter 80mg
Lumefantrine 480mg
Each Tablets of Emzor Paracetamol contains:
Paracetamol 500mg
PHARMACOLOGICAL ACTION
Artemether is a semisynthetic chiral acetal derivative of artemisimin. It interferes with parasite transport proteins, produces disruption of mitochondrial function, inhibits angiogenesis, and modulates host immune function. Artemeter and its active metabolite have been estimated to reduce parasite biomass by approximately 10,000-fold per reproductive cycle (every 2 days).
Lumafantrine is a racemic mixture of a synthetic fluorine derivative and is structurally related to guanine, mafloquine, and halofantrine. It interferes with the conversion of heme, the toxic intermediate step produced during hemoglobin break-down, to non-toxic hemozoin. Accumulation of heme and free radicals results in parasite death.
Artemether like other artemisinin derived compounds, acts quickly to rapidly reduce the parasite burden, while lumefantrine serves as a longer acting agent to eliminate remaining parasites. The combination in strains known to be resistant to traditional antimalarials such as chloroquine, and can be used for infections acquired in areas known to have parasites that are multridrug-resistant.
The mechanism of action of paracetamol is believed to be inhibition of cycloxygenase (COX), with a predominant effect on COX-2. Inhibition of COX enzymes prevents the metabolism of arachidonic acid to prostaglandin H2 an unstable intermediate byproduct which is converted to pro-inflamatory compounds.
In the central system, inhibition of COX enzymes reduces concentrations of prostaglandin E2, which lowers the hypothalamic set point to reduce fever, and activation of descending inhibitory serotonergic pathways to produce analgesia.
INDICATIONS
Lokmal QS is indicated for the treatment of malaria in children and adults caused by all forms of plasmodium including severe malaria caused by multiple drug resistant strains of P.falciparum.
Paracetamol is indicated for the relief of pain, headache and feverish Conditions.
PHARMACEUTICAL PRECAUTIONS AND CONTRAINDICATIONS
LOKMAL Q5 is contraindicated in individuals who are hypersensitive to artemether and lumenfatrine and in the first trimester of pregnancy, except otherwise prescribed by a physician.
Due to long elimination half life of lumefantrine, it is recommended that breastfeeding should not start until at least one week after stopping artemether/lumefantrine combination treatment.
DRUG INTERACTIONS
Specific negative drug-drug interaction was not seen. Artemether potentiates the antimalarials. Grapefruit is known to reduce the absorption and metabolism of Artemether / Lumefantrine.
DOSAGE AND ADMINISTRATION
Adult and children
> 35kg (14years and above)
Day 1: 0Hr, 8Hrs later – 1 tablet each
Day 2: 1 tablet Morning and 1 tablet Night
Day 3: 1 tablet Morning and 1 tablet Night
Tablets are taken orally (by mouth)
BODY WEIGHT (AGE)
EMZOR PARACETAMOL TABLETS
Adult and children
> 35kg (14years and above)
Day 1: Morning 2 Tablets, Afternoon 2 Tablets,
Night 2 Tables
Day 2: Morning 2 Tablets, Afternoon 2 Tablets
Night 2 Tablets.
SIDE EFFECTS OF LOKMAL Tablets
Nausea
Vomiting
Abdominal pains
Allergy
Skin reactions
Nightmares for some persons
Elevates liver enzymes
May damage red blood cell esp in persons with G6PD deficiency.
Heartburns in some persons.
Cost of Lokmal Tablets
The price of a pack of lokmal lokmal is around #600 -#1,000 Naira and they are readily available in chemist shops and pharmacies across Nigeria.
