Antimalarial Class
Artemether-Lumefantrine
Brand: Coartem / Artefan / generic AL
Subclass: ACT (artemisinin combination therapy)
PK:
t½ 3 days | Clearance: hepatic
moderate
AE: Headache, dizziness, GI upset, palpitations; mild transient ECG changes (QT prolongation) possible.
AE: Headache, dizziness, GI upset, palpitations; mild transient ECG changes (QT prolongation) possible.
Artesunate
Brand: Artesunate (IN/BD generic)
Subclass: Artemisinin derivative
PK:
t½ 1 hours | Clearance: hepatic
Max Dose: 600 day
Max Dose: 600 day
moderate
AE: Generally well tolerated; transient neutropenia, mild liver enzyme elevation, rare delayed hemolysis after parenteral therapy.
AE: Generally well tolerated; transient neutropenia, mild liver enzyme elevation, rare delayed hemolysis after parenteral therapy.
Atovaquone–Proguanil
Brand: Malarone
Subclass: Mitochondrial ETC inhibitor + DHFR inhibitor
PK:
t½ 48 hours | Clearance: hepatic
moderate
AE: Abdominal pain, nausea, vomiting, headache, elevated liver enzymes, mouth ulcers (due to proguanil). Rare: hallucinations.
AE: Abdominal pain, nausea, vomiting, headache, elevated liver enzymes, mouth ulcers (due to proguanil). Rare: hallucinations.
Chloroquine
Brand: Nivaquine / generic chloroquine
Subclass: 4-aminoquinoline
PK:
t½ 30 days | Clearance: hepatic
Max Dose: 2500 day
Max Dose: 2500 day
moderate
AE: Pruritus, GI upset, headache, visual disturbances, rare retinopathy, QT prolongation at high dose or IV use.
AE: Pruritus, GI upset, headache, visual disturbances, rare retinopathy, QT prolongation at high dose or IV use.
Hydroxychloroquine
Brand: HCQ / Plaquenil
Subclass: 4-aminoquinoline derivative
PK:
t½ 45 days | Clearance: mixed
moderate
AE: Retinopathy, QT prolongation, hypoglycemia, GI upset, rash, pruritus, dizziness.
AE: Retinopathy, QT prolongation, hypoglycemia, GI upset, rash, pruritus, dizziness.
Mefloquine
Brand: Lariam / generic mefloquine
Subclass: Quinoline-methanol
PK:
t½ 20 days | Clearance: hepatic
Max Dose: 1500 week
Max Dose: 1500 week
severe
AE: Neuropsychiatric reactions (anxiety, depression, nightmares, psychosis), dizziness, nausea, vomiting, bradycardia, rare seizures.
AE: Neuropsychiatric reactions (anxiety, depression, nightmares, psychosis), dizziness, nausea, vomiting, bradycardia, rare seizures.
Primaquine
Brand: Primaquine phosphate
Subclass: 8-aminoquinoline
PK:
t½ 7 hours | Clearance: hepatic
Max Dose: 30 day
Max Dose: 30 day
severe
AE: GI upset, methemoglobinemia, dose-related hemolytic anemia (especially in G6PD deficiency).
AE: GI upset, methemoglobinemia, dose-related hemolytic anemia (especially in G6PD deficiency).
Quinine
Brand: Quinimax / Quinine sulfate (generic)
Subclass: Cinchona alkaloid
PK:
t½ 11 hours | Clearance: hepatic
Max Dose: 2000 day
Max Dose: 2000 day
severe
AE: Cinchonism (tinnitus, headache, nausea, visual disturbance), hypoglycaemia, hypotension (IV), QT prolongation, hemolysis in G6PD deficiency, rare thrombocytopenia.
AE: Cinchonism (tinnitus, headache, nausea, visual disturbance), hypoglycaemia, hypotension (IV), QT prolongation, hemolysis in G6PD deficiency, rare thrombocytopenia.