Dihydroartemisinin/piperaquine

Dihydroartemisinin/piperaquine
Combination of
Dihydroartemisinin Antimalarial
piperaquine Antimalarial
Clinical data
Trade names DuoCotecxin, Artekin, Eurartesim, others
Synonyms Dihydroartemisinin/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]

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]

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]

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]

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:

  • Artekin (Holleykin)
  • Eurartesim (Sigma Tau; by Good Manufacturing Practices)
  • Diphos (Genix Pharma)
  • Timequin (SAMI Pharma )
  • Duocotecxin (Holley Pharm)
  • Malacur (Elder Pharmaceuticals for SALVAT Laboratories)
  • Ridmal (Ajanta Pharma Limited)

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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