Q: I would like to know if Quinine and Alpha Beta Arteether (Inj. E-Mal) can be given together to the same patient? If so, can you provide me with some literature and references?

A:Arteether (E-Mal) is indicated in chloroquin-resistant and/or multi-drug resistant strains of malaria caused by P. falciparum. Quinine is also used for the same purpose. Scientifically, there is no prohibition in using the two drugs together, though it should not be necessary. Arteether is generally used in combination with either mefloquine or halofantrine. It ought to be kept in mind that adverse effect profile of arteether and quinine is similar and additive, such as tinnitus and QT interval prolongation. One will need to be extra cautious in patients at risk of cardiac disorders while using the two drugs together.