Archive for the ‘Fansidar’ Tag

What are the components of the fixed-combination antimalarials?   Leave a comment

Conventional formulations
Fansidar: sulfadoxine 500mg + pyrimethamine 25mg

Malarone: atovaquone 250mg + proguanil 100mg
(paeds Malarone tab: atovaquone 62.5mg + proguanil 25mg)

Maloprim: dapsone 100mg + pyrimethamine 12.5mg
 

Artemisinin-based
Coartem (Riamet): artemether 20mg + lumefantrine 120mg

Artekin: dihydroartemisinin 40mg + piperaquine 320mg

DNP: dihydroartemisinin 160mg + naphthoquine 400mg + trimethoprim 200mg

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Posted February 24, 2010 by absinthemisia in malaria, malaria prophylaxis

Tagged with , , , , , , ,

What are the salt & base equivalents for antimalarials?   Leave a comment

by convention, quinine dosage is given in salt units while its derivatives are usually given in base units, except for mefloquine which is complicated. The highlighted units below are the ones in common use. Remember to state clearly whether you are referring to the base or salt when writing the prescription! This discussion applies to oral formulations only.

Quinine sulphate: 300mg salt = 250mg base

Chloroquine phosphate: 150mg base = 250mg salt

Hydroxychloroquine: 155mg base = 200mg salt

Mefloquine hydrochloride: 250mg salt = 228mg base (in the United States)
(however, in some countries mefloquine is available as 250mg base which = 274mg salt; in these countries I presume that “250mg mefloquine” refers to the base formulation, and patients receive a 9.6% higher dosage than their counterparts elsewhere. But, most internationally-recognised publications refer to the 250mg salt formulation available in the US.)

Amodiaquine hydrochloride: 200mg base = 260mg salt

Primaquine phosphate: 15mg base = 26.3mg salt
 

Ref:

  1. White NJ. The Treatment of Malaria. N Engl J Med 1996 Sep 12;335(11):800-806.
  2. Freedman DO. Malaria Prevention in Short-Term Travelers. N Engl J Med 2008 Aug 7;359(6);603-12. Table 3, Drug Regimes for Prophylaxis Against Malaria; p.608.
  3. Lariam package insert (Roche – US), rev Sep 2008 (PDF file)
  4. Drugs.com (Archived) [Internet]. c2000-2009 [revised 2001 Jan 24; cited 2009 May 8]. Available from:
    http://www.drugs.com/mmx/mefloquine-hydrochloride.html#citec00139613

Malaria Endemic and Resistance Patterns of the World   1 comment

links below lead to the CDC public-access website, updated July 2011

Malaria endemicity:

for more detailed information by country, see Yellow Fever & Malaria Information by Country, CDC website.

 

Malaria resistance:
Most notably resistance of P. falciparum to chloroquine and mefloquine. Updated 10 Oct 2011.

  • Resistance to chloroquine: all areas except the Carribean, Central America west of the Panama Canal, and some countries in the Middle East.
  • Resistance to Fansidar: Amazon river basin of S. America, much of Southeast Asia and other parts of Asia, large parts of Africa.
  • Resistance to mefloquine: borders of Thailand with Myanmar and Cambodia, western provinces of Cambodia, eastern states of Myanmar, Myanmar-China border, along the Laos-Myanmar border and adjacent Thai-Cambodia border, and southern Vietnam. see Distribution of mefloquine-resistant malaria in Indochina

 
Ref:
CDC Travelers’ Health — Yellow Book 2012. Chap 3: Infectious Diseases Related to Travel: Malaria [Internet]. Atlanta (GA): Centers for Disease Control and Prevention; 2011 Jul 1. [updated 2011 Jul 1; cited 2011 Oct 10]. Available at:
http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/malaria.htm