Why it's used

Lonart ds Tablet is used to treat acute and uncomplicated malarial infections in patients weighing 5 kg (11 lb) and above. It is a prescription medicine. This medicine works by killing the parasitic organisms that cause malaria by blocking the synthesis of nucleic acid and proteins. This medicine helps by preventing the growth of malarial parasites.
When not to use
Lonart ds Tablet will not work to prevent malaria. Lonart ds will not work against patients who have severe or complicated malarial infections.
Antimalarial
Lonart ds belongs to a class of medicines called Antimalarial. Antimalarial.

How to use

Read the medicine guide provided by your pharmacist, your doctor, or the medicine company. If you have any questions related to Lonart ds, ask your doctor or pharmacist. Use Lonart ds Tablet as per the instructions provided by your doctor.
Lonart ds is eaten with food. Infants and children who are unable to swallow the tablets, Lonart ds tablets must be crushed and mixed with a small amount of water (one to two teaspoons). If the patient vomits within 1 to 2 hours of taking the Lonart ds, a repeated dose of Lonart ds should be used. On the other hand, if the patient vomits the repeated dose, the patient should follow another alternative antimalarial for treatment.
The typical dose of Lonart ds for adults is 80 mg/480 mg as a single initial dose, repeated as 80 mg/480 mg after 8 hours in a day and then followed by four doses (80 mg/480 mg) twice daily for the following two days. The usual dose for children is 20 mg/120 mg as a single initial dose, repeated as 20 mg/120 mg after 8 hours in a day and then followed by one dose (20 mg/120 mg) twice daily for the following two days. The maximum dose for adult patients of Lonart ds is 160 mg/960 mg per day.
Lonart ds should be used as directed by the doctor even if you feel well, or even if you think that there is no need for you to use your medicine.
Discuss with your doctor if your condition does not improve or worsens. Discuss with your doctor if fever, chills (cold), muscle pain, and headache.
If you are giving Lonart ds Tablet to a child, be sure to use a product that is for use in children. Use the child's weight or age to find the right dose from the product package or medicine label. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.
Avoid grapefruit juice while using Lonart ds. Grapefruit juice increases the amount of medicine in the blood.
Medicines may be recommended for uses other than those listed in the medicine guide. You should not use Lonart ds Tablet for conditions or symptoms for which it was not prescribed. Do not give Lonart ds Tablet to other people, even if they have the same conditions or symptoms that you have. The use of this medicine without the advice of a doctor may cause harm.
Follow storage instructions on the product package if available. Store Lonart ds Tablet 15°C-30°C (59°F-86°F), and away from moisture. Store this medicine away from children and pets.

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How to take Lonart ds

The dose and frequency of using Lonart ds will depend on the following factors:
  • age of the patient
  • the weight of the patient
  • patient's health
  • medicines recommended by the doctor
  • any other medicines being used
  • herbal supplements being used
  • response to the medicine

Lonart ds Dosage

Dosage for acute and uncomplicated malarial infections in patients weighing 5 kg (11 lb) and above

Adult (adult patients with a body weight of 35 kg (77 lb) and above)
  • Recommended: 80 mg/480 mg as a single initial dose, repeated as 80 mg/480 mg after 8 hours in a day and then followed by 80 mg/480 mg twice daily for the following two days
Children (children with a body weight of 5 kg (11 lb) to less than 15 kg (33.1 lb))
  • Recommended: 20 mg/120 mg as a single initial dose, repeated as 20 mg/120 mg after 8 hours in a day and then followed by one dose (20 mg/120 mg) twice daily for the following two days
Children (children with a body weight of 15 kg (33.1 lb) to less than 25 kg (55.1 lb))
  • Recommended: 40 mg/240 mg as a single initial dose, repeated as 40 mg/240 mg after 8 hours in a day and then followed by one dose (40 mg/240 mg) twice daily for the following two days
Children (children with a body weight of 25 kg (55.1 lb) to less than 35 kg (77.2 lb))
  • Recommended: 60 mg/360 mg as a single initial dose, repeated as 60 mg/360 mg after 8 hours in a day and then followed by one dose (60 mg/360 mg) twice daily for the following two days
Children (children with body weight of 35 kg (77.2 lb) and above)
  • Recommended: 80 mg/480 mg as a single initial dose, repeated as 80 mg/480 mg after 8 hours in a day and then followed by one dose (80 mg/480 mg) twice daily for the following two days

Minimum Age

2 months

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Tablet
Strength: 20mg/120mg

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed dose.

Overdose

What to do if you overdose on Lonart ds?
In case of overdose, supportive care and treatment according to symptoms should be given. Also, appropriate monitoring of electrocardiography (ECG) and blood potassium should be done.
If you think you have overdosed on Lonart ds Tablet, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Lonart ds

Before you use Lonart ds Tablet, discuss with your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.
Before you use Lonart ds, tell your doctor of your medical and health history including the following: prolonged heartbeat (QT prolongation), low blood potassium level, decreased heart rate (bradycardia), or heart attack (myocardial ischemia).
The use of this medicine may change haematocrit level. Use of Lonart ds can lead to a decrease in the ratio of the volume of red blood cells (hematocrit level).
The use of this medicine may change platelet count. Use of Lonart ds may increase or decrease the number of the platelet count.
The use of Lonart ds Tablet may change white blood cell count. Use of Lonart ds can lead to increased or decreased the level of white blood cell count.
The use of this medicine may change alanine transaminase level. The level of alanine transaminase has been found to increase on treatment with Lonart ds.
The use of Lonart ds Tablet may change aspartate aminotransferase level. The level of aspartate aminotransferase has been found to be increased during treatment with Lonart ds.
Lonart ds Tablet can make you feel sleepy. Be careful when using any machinery, driving a vehicle, or doing any other activity that needs you to be fully alert. The consumption of alcohol with Lonart ds Tablet can worsen the sleepiness.
The use of Lonart ds Tablet during pregnancy should only be when required. Use this medicine only if the potential benefit outweighs the potential risk to the fetus. Consult with your doctor on the use of Lonart ds Tablet during breastfeeding. It is unknown wheter Lonart ds passes into breast milk. Consult with your doctor on the use of Lonart ds Tablet, if you are trying to conceive.

What precautions should be taken during Pregnancy and Nursing, and administering Lonart ds to Children or the Older Adults?

Pregnant Women

Only When Necessary
Warning: Use this medicine only if the potential benefit outweighs the potential risk to the fetus.

Breastfeeding

Precaution
Warning: It is not known whether Lonart ds passes into breast milk, use this medicine only if the potential benefit justifies the potential risk to the infant.

Younger Adults Population

Possibly safe
Warning: The effectiveness and safety data of Lonart ds have been established in children weighing 5 kg or more, but the safety and efficacy data have not been established in children who weigh less than 5 kg.

Older Adults Population

No Known Risk
Warning: No specific pharmacokinetic investigations have been conducted in patients older than 65 years.

Lonart ds Side-effects

The following side-effects may commonly occur when using Lonart ds Tablet. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in children when using Lonart ds Tablet. Discuss with your doctor if any of these side-effects last for a long time or are severe:
Rarely, the use of Lonart ds Tablet may cause the following side-effects:
  • a disorder characterized by walking difficulties (gait disturbance)
  • a skin infection that causes red sores on the skin (impetigo)
  • accumulation of pus in confined tissue spaces, caused by a bacterial infection (subcutaneous abscess)
  • back pain
  • chills
  • cough
  • decreased number of eosinophils in the blood (eosinophilia)
  • delayed development (fine motor delay)
  • difficulty in swallowing (dysphagia)
  • ear infection
  • enlarged liver (hepatomegaly)
  • enlarged spleen (splenomegaly)
  • fatigue
  • feeling of discomfort
  • flu
  • hematocrit decreased
  • hives
  • increased platelet count
  • indigestion
  • inflammation of the lining of bronchial tubes in the lungs (bronchitis)
  • insomnia
  • intense itching
  • involuntary contractions and relaxations of muscle (clonus)
  • involuntary movement of the eyes (nystagmus)
  • irritation and inflammation of stomach and intestinal area (gastroenteritis)
  • lack of coordination and balance
  • mood swings
  • overactive or over responsive reflexes (hyperreflexia)
  • pain relating to the pharynx and the larynx (pharyngoIaryngeal pain)
  • painful pus (abscess)
  • parasitic infection (helminthic and hookworm infection)
  • presence of proteins in urine
  • reduced sensation of touch (hypoaesthesia)
  • ringing in the ears
  • stomach pain
  • swelling in the lower layer of skin
  • uncontrollable movements of the body (tremor)
  • vertigo
The following severe side-effects may also occur when using Lonart ds Tablet:
  • urinary system disorders
    Symptoms: urinary tract infection presence of blood in the urine (hematuria)
  • stomach and intestinal disorders
  • lung disorders
    Symptoms: inflammation and narrowing of airways of lungs (asthma), inflammation of air sacs (pneumonia) upper and lower respiratory tract infection
  • Symptoms: a decrease in the total number of red blood cells (anemia)
  • eye disorders
    Symptoms: inflammation or infection of the outer membrane of the eye (conjunctivitis)
  • psychiatric disorders
    Symptoms: state of anxiety (agitation)
  • liver problems
    Symptoms: increased liver enzymes (aspartate aminotransferase alanine aminotransferase)
  • heart disorders
    Symptoms: prolonged heartbeat (QT prolongation)
  • metabolism and nutrition disorders
    Symptoms: low levels of potassium in the blood
Your doctor has prescribed this Lonart ds because they have judged that the benefits outweigh the risks posed by side-effects. Many people using this medicine do not have serious side-effects. This is not a complete list of possible side-effects for Lonart ds.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Lonart ds by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Children

Following are the side-effects of this medicine in young patients:

Mild Allergic Reactions

Following are the symptoms of mild allergic reactions to this medicine:

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
  • fluid filled blistering due to a side-effect to certain drugs (bullous eruption)
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Parasitic infection (Plasmodium vivax infection)

Recurring malaria caused by P. vivax requires additional therapy with other antimalarial agents to obtain complete removal of malarial parasites from the body (radical cure).

Kidney damage

Take necessary precautions while using Lonart ds in patients with severe kidney damage. In these patients, it is advised to monitor ECG and blood potassium levels.

Liver Damage

Caution should be used in dosing patients with severe liver damage. In these patients, it is advised to monitor ECG and blood potassium levels.

First trimester of pregnancy

Lonart ds should not be used in pregnancy (first trimester) in situations where other proper and adequate antimalarials are available.

Heart rhythm disorder (prolongation of the QT Interval)

Patients with congenital heart rhythm disorders such as prolongation of the QT interval, disturbances of electrolyte balance, use of few medicines (calcium channel blockers, antidepressants, antibiotics, fluoroquinolones, antifungal agents and non-sedating antihistaminics) are at an increased risk. Such patients should avoid the use of Lonart ds in these conditions.

Use of Lonart ds with other antimalarials

The patients with combined use of Lonart ds with other antimalarial drugs (mefloquine, quinine, and halofantrine) are at an increased risk. The combined use of Lonart ds with other antimalarial drugs may potentiate the additive effects on the QT interval. Close monitoring by proper food intake is required in patients using mefloquine. An ECG monitoring is recommended in patients using quinine. Further, treatment with Lonart ds is not recommended within one month after the intake of last halofantrine dose.

Drug Interactions with CYP3A4 substrates

The combined use of Lonart ds with CYP3A4 substrates may result in decreased levels of the substrate and loss of its efficacy. Use of CYP3A4 inhibitors (grapefruit juice) may result in increased levels of Lonart ds and further leads to the prolonged heartbeat (QT prolongation). On the other hand, the combined use of CYP3A4 inducers with Lonart ds may result in decreased levels of Lonart ds and loss of antimalarial efficacy. Take necessary precautions while using Lonart ds with CYP3A4 substrates.

Drug Interactions with CYP2D6

When Lonart ds is taken with drugs that are metabolized by CYP2D6 may notably increase the levels of the drugs metabolized by CYP2D6 in the blood and increase the risk of side-effects. Many of the drugs metabolized by CYP2D6 can cause heart rhythm disorder. Drugs metabolized by CYP2D6 should not be used with Lonart ds due to the possible additive effect on the time of ventricular activity (e.g., imipramine, flecainide, clomipramine, amitriptyline).

Recurrence of an undesirable condition (Recrudescence)

Food enhances the absorption rate of artemether and lumefantrine after taking Lonart ds. Patients who remain distaste to food during therapy should be closely monitored as the chance of recrudescence may be higher in them. In the event of recurrence of Plasmodium parasitic infection after treatment with Lonart ds, patients should be treated with another antimalarial drug.

Interactions with Lonart ds

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Your doctor's guidelines may need to be followed while taking this medicine along with quinine, which is used to treat malaria. When a single dose of quinine is given intravenously with the final dose of a 6-dose regimen of Lonart ds, it results in the decreased exposure to artemether which is not clinically significant. Patients should be cautious while using quinine and other drugs that cause heart rhythm disorder due to the long elimination half-life of lumefantrine and the possibilities for additive QT effects.
Lonart ds Tablet interacts with hormonal contraceptives, which are used to prevent pregnancy, and antiretroviral drugs which are used for the treatment of HIV infection. Use of Lonart ds may decrease the effectiveness of hormonal contraceptives. Take necessary precautions while using Lonart ds in patients taking anti-retroviral drugs as it may increase the levels of lumefantrine and further leads to QT prolongation. Lonart ds should be used cautiously in patients during anti-retroviral therapy as it may decrease the levels of the Anti-Retroviral drugs resulting in loss of efficacy. Reduction in lumefantrine or artemether levels may result in the loss of antimalarial potency of Lonart ds. Patients using an oral, transdermal patch, or systemic birth control measures are advised to use anti-retroviral drugs, such as protease inhibitors and non-nucleoside reverse transcriptase inhibitors, which are known to have competition or induction for CYP3A4.
There may be an interaction of Lonart ds with mefloquine, which is used to prevent or treat malaria. When three doses of mefloquine are taken followed 12 hours later by a six-dose regimen of Lonart ds showed no effect of mefloquine on blood levels of the artemether/DHA or artemether ratio. However, exposure to lumefantrine was decreased, possibly due to lower absorption secondary to a mefloquine-induced reduction in the production of bile. Proper monitoring for reduced efficacy in such patients should be done, and when Lonart ds is taken, food consumption should also be promoted.
Lonart ds Tablet may interact with ketoconazole, which is used to treat fungal infections. When ketoconazole (a potent CYP3A4 inhibitor) is taken with a single dose of Lonart ds, it may lead to a moderate increase in exposure to dihydroartemisinin (a metabolite of artemether), artemether, and lumefantrine. Due to the potential for increased levels of lumefantrine which could lead to heart rhythm disorder, Lonart ds should be used cautiously with drugs that block CYP3A4 enzyme.
Special instructions need to be followed while taking this medicine along with CYP2D6 substrates, which is an enzyme and used in the treatment of mental disorders. Lumefantrine causes blockage of CYP2D6 in vitro. When Lonart ds is given in combination with the drugs that are broken down by CYP2D6, it results in a significant increase in the blood levels of the drug given in combination and increases the risk of side effects. In addition to this, many drugs which are broken down by CYP2D6 can result in the prolonged heartbeat (prolong the QT interval). Drugs which are broken down by CYP2D6 should not be given with Lonart ds due to the possible additive effect on the QT interval including drugs such as flecainide, imipramine, amitriptyline, clomipramine.
Your doctor's guidelines may need to be followed while taking this medicine along with drugs which may cause prolonged heartbeat. The use of Lonart ds with drugs that prevent increased or decreased heartbeats of classes I A and III; neuroleptics and antidepressant agents, certain antibiotics may result in abnormal heart rhythm. The Lonart ds should not be used in combination with the drugs that may cause prolonged heartbeat.
Lonart ds Tablet interacts with nevirapine, which is used to treat HIV/AIDS. Patients taking nevirapine may experience decreased levels of artemether and dihydroartemisinin in the blood. But the levels of lumefantrine were not significantly reduced by nevirapine. The use of Lonart ds may lower the blood levels of nevirapine. Take necessary precautions while using Lonart ds in patients taking nevirapine.
Special instructions need to be followed while taking this medicine along with lopinavir/ritonavir, which is used to treat HIV/AIDS. The use of lopinavir and ritonavir reduced the absorption of artemether and DHA by approximately 40% but increased the absorption to lumefantrine by about 2.3- fold. Patients taking lopinavir or ritonavir should take necessary precautions while using Lonart ds.
There may be an interaction of Lonart ds with efavirenz, which is used to treat HIV/AIDS. Efavirenz reduces the absorption of artemether, DHA, and lumefantrine by approximately 50%, 45%, and 20%, respectively. Patients taking efavirenz should take necessary precautions while using Lonart ds.
Lonart ds Tablet may interact with drugs broken down by CYP450 enzymes. When Lonart ds is given in combination with substrates of CYP3A4, it may lead to decreased levels of the substrate and possible loss of efficacy of the substrate. Studies in humans have also shown that artemisinins have some capacity to induce CYP3A4 and CYP2C19 and block CYP2D6 and CYP1A2. Although the extent of the changes was generally low, it is possible that these effects could change the response of the drugs that are predominantly broken down by these enzymes.
This page does not contain all the possible interactions of Lonart ds Tablet. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Interactions of Lonart ds by Severity

Severe

The following medicines are usually not to be taken together without consulting with your doctor or pharmacist.

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Lonart ds be not used?

Severe allergic reaction

Lonart ds is not recommended in patients who are allergic to artemether and lumefantrine. These patients may have the following symptoms if they use this medicine:

Severe malaria

The use of Lonart ds in patients with severe malaria is not recommended according to the world health organization (WHO).

Patients taking drugs which are broken down by cytochrome enzyme CYP2D6

The use of Lonart ds is not recommonded in patients who are on treatment with any drug that is broken down in the body by the cytochrome enzyme CYP2D6 for example metoprolol, imipramine, amitryptyline, clomipramine.

Patients with the family history of heart problems

Lonart ds is not advised in patients who have a history of fatal events or abnormalities in the heart (congenital prolongation of the QTc interval on electrocardiograms) or with any other condition that is known to prolong the QTc interval.

Drugs that can prolong the QTc interval

The use of Lonart ds is not recommended in patients who are on treatment with drugs that are known to prolong the QTc interval such as antiarrhythmics of classes IA and III; neuroleptics; antidepressive agents; antibiotics including macrolides, fluoroquinolones, imidazole and triazole antifungal agents; certain non-sedating antihistamines such as terfenadine and astemizole; cisapride; flecainide which thereby result in abnormal heartbeats.

Patients with abnormalities in heartbeat

Lonart ds is not recommended in patients who have a history of symptomatic abnormalities in heartbeats or congestive heart failure which is accompanied by reduced left ventricular ejection fraction, which is the total amount of blood that the left ventricle pumps with each heartbeat.

Disturbed electrolyte balance

Patients with electrolyte imbalance such as low levels of potassium or reduced levels of magnesium in blood should not use Lonart ds.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Lonart ds is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Lonart ds Tablet .
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