Artesunate/ Amodiaquine

• Fixed-dose combinations (per tablet):
• Artesunate 25/50/100 mg + Amodiaquine base 67.5/135/270 mg (or salt equivalent)
• Formulations exist for pediatric and adult use.

• Take with or after food to reduce GI side effects.
• Complete full 3-day course even if symptoms improve early.
• Monitor for signs of liver dysfunction or blood cell abnormalities, especially with repeated courses.
• Do not repeat treatment within 28 days due to toxicity risks.

Mechanism of Action:

• Artesunate: Rapid parasite clearance by generating free radicals.
• Amodiaquine: Inhibits hemozoin formation in parasites, leading to toxic buildup of heme.

Pharmacokinetics:

• Artesunate: Very short half-life, fast acting.
• Amodiaquine: Converted to active metabolite desethylamodiaquine, long half-life (9–18 days), providing sustained antimalarial effect.

Common:

• Nausea, vomiting
• Dizziness
• Weakness (asthenia)
• Abdominal pain
• Loss of appetite

Serious (rare):

• Hepatotoxicity
• Neutropenia/agranulocytosis
• Extrapyramidal symptoms (tremors, rigidity, dystonia)

• Known hypersensitivity to artesunate or amodiaquine
• History of agranulocytosis or hepatic impairment during previous use of amodiaquine
• Severe hepatic or renal impairment
• Active liver disease

• Hepatotoxic agents: May increase risk of liver injury.
• Other antimalarials: Avoid combining with other ACTs or quinoline-based drugs.
• Enzyme inducers/inhibitors: May affect amodiaquine metabolism (via CYP2C8).