Artemether / Lumefantrine (Coartem)

How Medicare covers it

Part D (forms used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

What it treats

Treatment of acute, uncomplicated malaria infections due to Plasmodium falciparum in patients 2 months of age and older weighing 5 kg and above, including in regions where chloroquine resistance has been reported. It is not approved for severe or complicated malaria or for prevention.

What it is for, in depth

Coartem is the standard artemisinin-based combination for uncomplicated falciparum malaria — the most dangerous malaria type — in patients from 2 months of age and 5 kg bodyweight, including where chloroquine no longer works. Artemether clears parasites fast and lumefantrine mops up the rest over the 3-day, 6-dose course, which must be taken with food to absorb properly. It is a treatment only: not for severe malaria and not for prevention. The main cautions are heart-rhythm (QT) effects and the strong CYP3A4 inducers that are contraindicated because they can make treatment fail. The formulary set is the single Coartem tablet concept.

How it works

Both ingredients attack the malaria parasite's food vacuole: artemether (an artemisinin derivative) and lumefantrine interfere with the parasite's handling of heme, producing toxic products that kill Plasmodium falciparum in red blood cells.

How it is taken

Tablets (artemether 20 mg / lumefantrine 120 mg) by mouth WITH FOOD: 6 doses over 3 days — an initial dose, a second dose after 8 hours, then twice daily for 2 more days. Adults and children 35 kg and over take 4 tablets per dose; smaller children take 1 to 3 tablets per dose by weight. Tablets may be crushed and mixed with a little water for children.

Common side effects

['Headache and dizziness', 'Loss of appetite', 'Nausea, vomiting, and abdominal pain', 'Joint and muscle pain', 'Tiredness and trouble sleeping']

Serious warnings

['QT prolongation (a heart-rhythm change) — avoid in patients with known QT prolongation or low potassium/magnesium, and with other QT-prolonging drugs', 'Serious allergic (hypersensitivity) reactions', 'Not for severe or complicated malaria, and not for malaria prevention (label limitations of use)']

Who should be careful

['People with known QT prolongation, low potassium, or low magnesium', 'People taking other QT-prolonging drugs or halofantrine within the past month', 'People taking strong CYP3A4 inducers (contraindicated)', 'People relying on hormonal contraception (effectiveness may be reduced)']

Major interactions

["Strong CYP3A4 inducers (rifampin, carbamazepine, phenytoin, St. John's wort) — contraindicated; they can make Coartem fail", 'CYP3A4 inhibitors — use cautiously (QT prolongation risk)', 'Other antimalarials and QT-prolonging drugs (including quinine, quinidine, and halofantrine within one month) — additive QT effects; use cautiously or avoid', 'Antiretroviral medicines — use cautiously (QT effects or loss of efficacy of either drug)', 'Hormonal contraceptives — effectiveness may be reduced; use an additional method', 'CYP2D6 substrate drugs — monitor for adverse reactions and QT prolongation']

Cost and saving notes

Coartem is a brand combination tablet; plans list it on a mid-level brand tier. Ask about a tier exception, and check Extra Help if your income is limited. The 2027 Part D out-of-pocket cap is $2,400 for the year, and the Medicare Prescription Payment Plan can spread that cost across the year.

Why it is in its tier

Artemether / Lumefantrine (Coartem) sits on Tier 4 in 86.92% of the plans that list it (4776 of 5495 listing plans). Tier 4 is the non-preferred tier — higher copays or coinsurance. The data-visible drivers: It is a brand-only product with no generic version in the formulary data, and the CMS dashboard puts its average Part D spending at about $569 per beneficiary for 2024 — a relatively low-cost drug, which matches where plans place it. It is listed by 100.0% of Part D plans. The tier shown is the most common one; individual plans vary.

Sources

• COARTEM (ARTEMETHER AND LUMEFANTRINE) TABLET [NOVARTIS PHARMACEUTICALS CORPORATION] — DailyMed
• MedlinePlus Drug Information

What official patient guides say

The combination of artemether and lumefantrine (Coartem) comes as a tablet to take by mouth with food twice a day for 3 days, as instructed by your doctor, who will tell you how many tablets to take for each dose. Always take it with food, and if you are not able to eat, call your doctor. If you have trouble swallowing the tablets, they may be crushed and mixed with 1 or 2 teaspoons of water in a clean container — drink the mixture right away, rinse the glass with more water and swallow the entire contents, and then eat or drink food such as milk, formula, pudding, or broth. If you vomit within 1 to 2 hours after taking a dose, take another full dose; if you vomit again after taking the extra dose, call your doctor. Take the medication until you finish the prescription, even if you feel better, and do not eat grapefruit or drink grapefruit juice while taking it. If you miss a dose, take it as soon as you remember it; however, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule — do not take a double dose to make up for a missed one. Keep the medication in the container it came in, tightly closed and out of reach of children, stored at room temperature and away from excess heat and moisture (not in the bathroom). Keep all appointments with your doctor; the prescription is probably not refillable, so call your doctor if you still have symptoms of infection after you finish the medication, or if you have a fever, chills, muscle pain, or headache soon after you finish treatment.

Source: MedlinePlus Drug Information

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 5.36284 per unit (COARTEM TABLETS) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-07

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 5,495 list Artemether / Lumefantrine (Coartem) — 100% of plans. Most of those plans put it on Tier 4: 4,776 plans, 86.9% of the plans that list it. Other plans place it on Tier 3 (595 plans), Tier 1 (123 plans) or Tier 2 (1 plans). For example: Aetna Medicare Dual Extra (HMO D-SNP) puts it on Tier 4; Aetna Medicare Dual Extra Care (PPO D-SNP) puts it on Tier 4; Aetna Medicare Value Plus (PPO) puts it on Tier 4. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.