Indication:

  • Treatment of uncomplicated malaria, specifically Plasmodium falciparum, including drug-resistant strains.
  • Recommended as part of Artemisinin-based Combination Therapy (ACT) to enhance efficacy and prevent resistance.

Dosage:

Adults and children ≥35 kg:

  • 1 tablet OD*3/7

Children <35 kg:

  • Dosage based on body weight; follow national guidelines or physician advice.
  • Artesunate: 100 mg
  • Sulfamethoxypyrazine: 500 mg
  • Pyrimethamine: 25 mg
  • Take one tablet daily for 3 days, with food to minimize stomach upset.
  • Do not skip doses—complete the full treatment even if symptoms resolve early.
  • Swallow whole; do not chew or crush unless advised.
  • Store in a cool, dry place away from light.

Artesunate:

  • Rapid-acting artemisinin derivative
  • Produces free radicals that damage parasite proteins
  • Short half-life; reduces parasite biomass quickly

Sulfamethoxypyrazine:

  • Long-acting sulfonamide
  • Inhibits dihydropteroate synthase, blocking folate synthesis in the parasite

Pyrimethamine:

  • Inhibits dihydrofolate reductase, preventing DNA synthesis

Combination action:

  • Artesunate clears parasites quickly.
  • Sulfamethoxypyrazine and pyrimethamine sustain antimalarial effect and prevent recrudescence by blocking parasite replication.

Common:

  • Nausea, vomiting
  • Dizziness
  • Headache
  • Abdominal discomfort
  • Loss of appetite

Serious (rare):

  • Allergic reactions (e.g., rash, anaphylaxis)
  • Hepatotoxicity
  • Blood disorders (anemia, leukopenia, thrombocytopenia)
  • Stevens-Johnson Syndrome
  • Hypersensitivity to artesunate, sulfonamides, or pyrimethamine
  • Severe hepatic or renal impairment
  • Pre-existing blood disorders
  • First trimester of pregnancy, unless life-saving
  • Folate antagonists (e.g., methotrexate, trimethoprim): Increased risk of folate deficiency.
  • Sulfonylureas: Risk of hypoglycemia.
  • Phenytoin and other anticonvulsants: May alter blood levels.
  • Other hepatotoxic drugs: Additive bone marrow suppression.
  • Antiretrovirals: May have interactions—monitor closely.

                                   Drug Status

Availability
Pregnancy
Breastfeeding
Schedule
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Co-Arinate FDC Adult 200mg/500mg/25mg Tablet 3’s Dafra Pharma Energia Pharma
Co-Arinate FDC Junior 100mg/250mg/12.5mg Tablet 3’s Dafra Pharma Energia Pharma