Dihydroartemisinin/piperaquine

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Dihydroartemisinin/piperaquine
Combination of
Dihydroartemisinin Antimalarial
piperaquine Antimalarial
Clinical data
Trade names DuoCotecxin, Artekin, Eurartesim, others
SynonymsDihydroartemisinin/piperaquine phosphate
Routes of
administration 		By mouth

Dihydroartemisinin/piperaquine (DHA/PPQ) is a fixed dose combination medication used in the treatment of malaria. [1] It is a combination of dihydroartemisinin and piperaquine. [1] Specifically it is used for malaria of the P. falciparum and P. vivax types. [2] [3] It is taken by mouth. [2]

Malaria Mosquito-borne infectious disease

Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases it can cause yellow skin, seizures, coma, or death. Symptoms usually begin ten to fifteen days after being bitten by an infected mosquito. If not properly treated, people may have recurrences of the disease months later. In those who have recently survived an infection, reinfection usually causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria.

Dihydroartemisinin chemical compound

Dihydroartemisinin is a drug used to treat malaria. Dihydroartemisinin is the active metabolite of all artemisinin compounds and is also available as a drug in itself. It is a semi-synthetic derivative of artemisinin and is widely used as an intermediate in the preparation of other artemisinin-derived antimalarial drugs. It is sold commercially in combination with piperaquine and has been shown to be equivalent to artemether/lumefantrine.

Piperaquine chemical compound

Piperaquine is an antiparasitic drug used in combination with dihydroartemisinin to treat malaria. Piperaquine was developed under the Chinese National Malaria Elimination Programme in the 1960s and was adopted throughout China as a replacement for the structurually similar antimalarial drug chloroquine. Due to widespread parasite resistance to piperaquine, the drug fell out of use as a monotherapy, and is instead used as a partner drug for artemisinin combination therapy. Piperaquine kills parasites by disrupting the detoxification of host heme.

Contents

Side effects are uncommon. [3] Concerns include the possibility of QT prolongation. [3] Versions are available for use in children. [2] Use in early pregnancy is not recommended. [3] The two medications work by different mechanisms. [3]

Pregnancy time when children develop inside the mothers body before birth

Pregnancy, also known as gestation, is the time during which one or more offspring develops inside a woman. A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy can occur by sexual intercourse or assisted reproductive technology. A pregnancy may end in a live birth, abortion, or miscarriage, though access to safe abortion care varies globally. Childbirth typically occurs around 40 weeks from the start of the last menstrual period (LMP). This is just over nine months, where each month averages 31 days. When measured from fertilization it is about 38 weeks. An embryo is the developing offspring during the first eight weeks following fertilization, after which, the term fetus is used until birth. Symptoms of early pregnancy may include missed periods, tender breasts, nausea and vomiting, hunger, and frequent urination. Pregnancy may be confirmed with a pregnancy test.

Dihydroartemisinin/piperaquine was approved for medical use in Europe in 2011. [2] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. [1] While it was available for about 6 USD per treatment course, efforts are underway as of 2010 to bring the price down one dollar per course. [3] It is commercially available in Africa and Asia. [2] It has been used to treat more than 4.5 million people as of 2017. [2]

A health system, also sometimes referred to as health care system or as healthcare system, is the organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations.

Pharmacology

Dihydroartemisinin (also known as dihydroqinghaosu, artenimol or DHA) is a drug used to treat malaria. Dihydroartemisinin is the active metabolite of all artemisinin compounds (artemisinin, artesunate, artemether, etc.) and is also available as a drug in itself. It is a semi-synthetic derivative of artemisinin and is widely used as an intermediate in the preparation of other artemisinin-derived antimalarial drugs.

Piperaquine is an antimalarial drug, a bisquinoline first made in the 1960s, and used extensively in China and Indochina as prophylaxis and treatment during the next 20 years. Usage declined in the 1980s as piperaquine-resistant strains of P. falciparum arose and artemisinin-based antimalarials became available. The combination dihydroartemisinin-piperaquine is an effective antimalarial that is used widely around the world. In South-East Asia, where resistance has emerged towards both artemisinin and piperaquine, the combination is being trialed with a third drug, namely mefloquine. [4]

Mefloquine pharmaceutical drug

Mefloquine, sold under the brand names Lariam among others, is a medication used to prevent or treat malaria. When used for prevention it is typically started before potential exposure and continued for several weeks after potential exposure. It can be used to treat mild or moderate malaria but is not recommended for severe malaria. It is taken by mouth.

Piperaquine is characterized by slow absorption and a long biological half-life, making it a good partner drug with artemisinin derivatives which are fast acting but have a short biological half-life.

Society and culture

This product is available in the market of several countries:

Related Research Articles

Antimalarial medications, also known as antimalarials, are designed to prevent or cure malaria. Such drugs may be used for some or all of the following:

Artemisinin chemical compound

Artemisinin and its semisynthetic derivatives are a group of drugs used against malaria due to Plasmodium falciparum. It was discovered in 1972 by Tu Youyou, a Chinese scientist, who was co-recipient of the 2015 Nobel Prize in Medicine for her discovery. Treatments containing an artemisinin derivative are now standard treatment worldwide for P. falciparum malaria. Artemisinin is isolated from the plant Artemisia annua, sweet wormwood, a herb employed in Chinese traditional medicine. A precursor compound can be produced using a genetically-engineered yeast, which is much more efficient than using the plant.

Artemether chemical compound

Artemether is a medication used for the treatment of malaria. The injectable form is specifically used for severe malaria rather than quinine. It may not be as effective as artesunate. It is given by injection in a muscle. It is also available by mouth in combination with lumefantrine, known as artemether/lumefantrine.

Artesunate chemical compound

Artesunate (AS) is a medication used to treat malaria. The intravenous form is preferred to quinidine for severe malaria. Often it is used as part of combination therapy, such as artesunate plus mefloquine. It is not used for the prevention of malaria. Artesunate can be given by injection into a vein, injection into a muscle, by mouth, and by rectum.

Proguanil chemical compound

Proguanil, also known as chlorguanide and chloroguanide, is a medication used to treat and prevent malaria. It is often used together with chloroquine or atovaquone. When used with chloroquine the combination will treat mild chloroquine resistant malaria. It is taken by mouth.

Artemether/lumefantrine, sold under the trade name Coartem among others, is a combination of the two medications artemether and lumefantrine. It is used to treat malaria caused by Plasmodium falciparum that is not treatable with chloroquine. It is not typically used to prevent malaria. It is taken by mouth.

Artesunate suppositories are used for the treatment of malaria. Artesunate is an antimalarial water-soluble derivative of dihydroartemisinin. Artemisinins are sesquiterpene lactones isolated from Artemisia annua, a Chinese traditional medicine. These suppositories are given rectally due to the risk of death from severe malaria, as described below.

Artelinic acid chemical compound

Artelinic acid is an experimental drug that is being investigated as a treatment for malaria. It is a semi-synthetic derivative of the natural compound artemisinin. Artelinic acid has a lower rate of neurotoxicity than the related artemisinin derivatives arteether and artemether, but is three times more toxic than artesunate. At present, artelinic acid seems unlikely to enter routine clinical use, because it offers no clear benefits over the artemesinins already available. Artelinic acid has not yet been evaluated for use in humans.

Amodiaquine chemical compound

Amodiaquine (ADQ) is a medication used to treat malaria, including Plasmodium falciparum malaria when uncomplicated. It is recommended to be given with artesunate to reduce the risk of resistance. Due to the risk of rare but serious side effects, it is not generally recommended to prevent malaria.

Artesunate/amodiaquine, sold under the trade name Camoquin among others, is a medication used for the treatment of malaria. It is a fixed-dose combination of artesunate and amodiaquine. Specifically it recommended for acute uncomplicated Plasmodium falciparum malaria. It is taken by mouth.

Mass drug administration administration of a medication to at-risk individuals in a population without individual diagnosis.

The administration of drugs to whole populations irrespective of disease status is referred to as mass drug administration (MDA).

Project 523 is a code name for the secret military project of the People's Republic of China during and after the Cultural Revolution, for antimalarial medications, which were urged in the Vietnam War. The name stood for 23 May, the day the project was launched in 1967. It was aimed at finding new drugs for malaria, the disease which claimed more lives than the actual battles. At the behest of Hồ Chí Minh, Prime Minister of the Democratic Republic of Vietnam, Zhou Enlai, the Premier of the People's Republic of China, convinced Mao Zedong, Chairman of the Communist Party of China, to start a mass project for development of new antimalarial drug "to keep [the] allies' troops combat-ready", as they put down in the meeting minute. More than 500 Chinese scientists were recruited. The project was divided into two streams, one for developing synthetic compounds, and the other for investigating traditional Chinese medicine. The latter proved to be the more fruitful, directly resulting in the discovery and development of a class of new antimalarial drugs called artemisinins. It was officially terminated in 1981.

The Affordable Medicines Facility-malaria (AMFm) is a financing mechanism intended to expand access to affordable and effective antimalarial medication. It works primarily through the commercial private sector, in addition to the public and non-governmental organization sectors which are the more traditional routes for development assistance in malaria control. Its goal is to drive down the price of the most effective malaria medicines so that millions of people can afford to buy them. The program has been called "one of the most important recent advances in fighting malaria" and "a triumph of international cooperation." The AMFm is hosted and managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria in Geneva, Switzerland.

Zhou Yiqing is a professor of medicine at the Institute of Microbiology and Epidemiology of the People's Liberation Army Academy of Military Medical Sciences. He was one of the scientists who participated in the Project 523 of the Chinese Government under Chairman Mao Zedong. The project resulted in the discovery of artemisinins, a class of antimalarial drugs, from the medicinal plant Artemisia annua.

Artesunate/mefloquine is a medication used to treat malaria. It is a fixed dose combination of artesunate and mefloquine. Specifically it is recommended to treat uncomplicated falciparum malaria. It is taken by mouth.

Artesunate/pyronaridine, sold under the brand name Pyramax, is a fixed dose combination medication for the treatment of malaria. It can be used for malaria of both the P. falciparum and P. vivax types. It combines artesunate and pyronaridine. It is taken by mouth.

Professor Adrianus Mattheus (Arjen) Dondorp is a Dutch intensivist and head of the Mahidol-Oxford Tropical Medicine Research Unit in Bangkok, Thailand. He has trained as an infectious diseases physician and has been living in Bangkok since 2000. He is best known for his research in severe falciparum malaria, a disease that requires intensive care in hospital, an interest he developed following studies in rheology.

References

  1. 1 2 3 "WHO Model List of Essential Medicines (20th List)" (PDF). World Health Organization. March 2017. Retrieved 29 June 2017.
  2. 1 2 3 4 5 6 "Eurartesim (dihydroartemisinin-piperaquine) | Medicines for Malaria Venture". www.mmv.org. Retrieved 13 December 2017.
  3. 1 2 3 4 5 6 "Dihydroartemisinin/Piperaquine Application for Inclusion in the 17th WHO Model List of Essential Medicines" (PDF). WHO. November 2010. Retrieved 29 June 2017.
  4. ↑ "TRAC II - Mahidol Oxford Tropical Medicine Research Unit". www.tropmedres.ac. Retrieved 28 July 2017.
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