Artequine

Description

Artesunate & Mefloquine Tablets combine two antimalarial drugs to treat uncomplicated malaria and multidrug-resistant strains of Plasmodium falciparum, prevalent in Pakistan’s endemic areas like Sindh and Balochistan. Artesunate rapidly reduces parasite numbers, while mefloquine prevents relapse, making it effective for travelers or residents in high-risk zones. Available in packs of 6 tablets, it’s priced around Rs. 300-400, prescription-only, and distributed through DRAP-registered pharmacies.

How It Functions

Artesunate, an artemisinin derivative, generates free radicals that damage Plasmodium parasites, disrupting their lifecycle. Mefloquine, a quinoline, interferes with parasite hemoglobin metabolism, preventing reproduction. Chemically, artesunate is dihydroartemisinin-10-α-succinate; mefloquine is (R*,S*)-2-piperidinyl-2,8-bis(trifluoromethyl)-4-quinolinemethanol. The combination clears parasites within 24-48 hours and prevents resistance, with effects lasting weeks.

Dosage Information

Adults: Typically, artesunate 200mg (4mg/kg) and mefloquine 750-1000mg (15-25mg/kg) over 3 days (e.g., artesunate 100mg + mefloquine 250mg daily). Children: Weight-based, e.g., 4mg/kg artesunate + 8-15mg/kg mefloquine daily for 3 days. Take orally with water, preferably with food to reduce stomach upset. Complete the 3-day course; consult physician for adjustments in kidney/liver issues or severe malaria.

Side Effects

• Very Common (>1 in 10): Nausea, vomiting, headache, dizziness.
• Common (up to 1 in 10): Abdominal pain, diarrhea, fatigue, insomnia, rash.
• Rare: Severe allergic reactions (swelling, breathing difficulty), neurological effects (seizures, confusion), liver enzyme elevation, heart rhythm changes.

Drug Interactions

May interact with:

• Anticonvulsants (e.g., phenytoin): Reduces mefloquine levels.
• Antiarrhythmics (e.g., amiodarone): Increases QT prolongation risk.
• Rifampicin: Lowers artesunate efficacy.
• Other antimalarials (e.g., quinine): Enhances toxicity.
• Antidepressants (e.g., SSRIs): Risks neurological side effects.

Indications

Approved for treating:

• Uncomplicated malaria caused by Plasmodium falciparum.
• Multidrug-resistant Plasmodium falciparum strains.

When Not to Use

Avoid in:

• Hypersensitivity to artesunate, mefloquine, or excipients.
• History of seizures, depression, or psychiatric disorders (mefloquine risk).
• Severe liver impairment or heart rhythm disorders.
• First trimester pregnancy or breastfeeding without physician approval.

Precautions

• Monitor for neurological symptoms (e.g., confusion, seizures); stop if severe.
• Use cautiously in heart conditions; check ECG for QT prolongation.
• Ensure hydration, especially in Pakistan’s hot climates or during fasting.
• Not for prophylaxis; use only for confirmed malaria treatment.
• Buy from DRAP-registered pharmacies; check holograms to avoid counterfeits.

Warnings

• Neurological effects: Mefloquine may cause serious psychiatric symptoms (e.g., anxiety, psychosis); seek urgent care.
• Heart rhythm: Risk of QT prolongation; avoid in arrhythmia patients.
• Pregnancy: Avoid in first trimester; consult physician for later use.
• Liver toxicity: Monitor enzymes in prolonged use or liver disease.
• Resistance: Complete course to prevent resistant strains, a concern in endemic Pakistan.

Additional Notes

• Pregnancy Category: Consult physician; category C, avoid in first trimester.
• Breastfeeding: Avoid; mefloquine passes into milk, risks infant toxicity.
• Availability: Common in endemic area pharmacies; generics like Artequin available.
• Stability: Stable at room temperature; discard expired tablets.
• Reporting: Log batch for side effects; report to DRAP for quality control.

Doctor Review

Dr. Khalid Mehmood, an infectious disease specialist in Karachi, notes Artesunate & Mefloquine’s rapid action against resistant malaria, critical in Pakistan’s border regions. DRAP data supports its combination efficacy, but Dr. Mehmood stresses neurological monitoring and confirming diagnosis to avoid misuse.

Disclaimer

This is general product information, not a prescription or medical advice. Consult your doctor or pharmacist for personal guidance