Maxillofac Plast Reconstr Surg.  2021;43(1):13. 10.1186/s40902-021-00300-y.

Adverse reaction to Coartem (artemether/ lumefantrine) resulting in oculogyric crisis

• Amponsah EK
• Sodnom-Ish B
• Anyetei-Anum AS
• Frimpong P
• Kim SM

• KMID: 2525732
• DOI: http://doi.org/10.1186/s40902-021-00300-y

Abstract

Background
Artemether/lumefantrine (AL), sold under the brand name Coartem, is the most common artemisininbased combination therapy for the treatment of malaria. Drug-induced oculogyric crisis is a neurological disorder characterized by frequent upward deviations of the eye. In the literature, no cases of Coartem-induced oculogyric crisis have been reported in Ghana.
Case presentation
A 19-year-old male patient, who presented fever measuring 37.9 °C, general body pains, and weakness was prescribed with antimalarial therapy artemether/lumefantrine, Coartem^®, from a local pharmacy. Just after initiation of treatment, the patient complained of double vision, involuntary upward eye deviation, and inability to close both eyes. The patient was diagnosed with Coartem-induced oculogyric crisis and was treated with the cessation of the causing agent and intramuscular injection of promethazine hydrochloride.
Conclusions
When a patient exhibits a neurological disorder, such as oculogyric crisis, with normal conscious state and normal vital signs, special attention should be given to obtaining a history of recently administered medications. Clinicians should recognize adverse reactions to drugs based on a thorough patient history and examination. The goal of this report was to present Coartem-induced oculogyric crisis.

Keyword

Antimalarial; Artemether-lumefantrine; Rapid diagnostic test; Oculogyric crisis; Dystonic reactions