Indications:
- Treatment of uncomplicated Plasmodium falciparum malaria, including multidrug-resistant strains.
- Often used as part of ACT (Artemisinin-based Combination Therapy) to reduce the risk of resistance.
Dosage (Adult):
- Artesunate 200 mg +OD*3/7 Mefloquine 400 mg.
- Total dose over 3 days: Artesunate 600 mg, Mefloquine 1200 mg.
Pediatric Dosing:
- Weight-based; consult specific treatment guidelines (e.g., WHO or national protocols).
- Fixed-dose combinations vary by manufacturer. Common formulations include:
- Artesunate 100 mg + Mefloquine 220 mg
- Artesunate 200 mg + Mefloquine 440 mg
- Tablets should be taken according to body weight and local guidelines.
- Take with food to improve mefloquine absorption and reduce GI upset.
- Complete the full 3-day course, even if symptoms resolve early.
- If vomiting occurs within 1 hour of dose, repeat the dose.
- Do not use for prophylaxis due to artesunate’s short half-life.
Mechanism of Action:
- Artesunate: Rapidly acting artemisinin derivative that generates free radicals inside parasitized erythrocytes, killing the parasite.
- Mefloquine: Inhibits heme polymerization in the parasite’s food vacuole, causing toxic heme accumulation.
Pharmacokinetics:
- Artesunate: Short half-life (~1 hr), rapid onset.
- Mefloquine: Long half-life (~2–4 weeks), provides long-lasting protection after treatment.
Common:
- Dizziness
- Nausea, vomiting
- Insomnia
- Headache
- Anorexia
- Abdominal pain
- Serious (mainly due to Mefloquine):
- Neuropsychiatric effects: anxiety, depression, hallucinations, psychosis
Seizures (rare)
- QT prolongation (rare, mainly with high doses)
- History of seizures or major neuropsychiatric disorders (especially with mefloquine)
- Known hypersensitivity to either drug
- Other QT-prolonging drugs: Increased risk of arrhythmia.
- Antidepressants/antipsychotics: May enhance CNS side effects.
- Beta-blockers and calcium channel blockers: Monitor cardiac function if co-administered.
- Anticonvulsants: May interact with mefloquine metabolism.
Drug Status
Availability | |
Pregnancy | |
Breastfeeding | |
Schedule |
BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
---|---|---|---|---|---|
Artequin Adult | 600mg/750mg | Tablet | 6’s | Acino Pharma | Goodman Agencies |
Artequin Child | 300mg/375mg | Tablet | 6’s | Acino Pharma | Goodman Agencies |
Artequin Pediatric | 50mg/125mg | Tablet | 3’s | Acino Pharma | Goodman Agencies |
Mefsunate | 100mg/200mg | Tablet | 3’s | Signature Healthcare | Signature Healthcare |