Artesunate and Mefloquine combination therapy
Artesunate-Mefloquine (AS-MQ) is one of the artemisinin-based combination therapies (ACTs) recommended by the World Health Organization (WHO) for the treatment of uncomplicated Plasmodium falciparum malaria
Mechanism of Action:
Artesunate: This is a semi-synthetic derivative of artemisinin derived from the plant Artemisia annua. It rapidly reduces the majority of the parasite biomass, acting against young and mature blood-stage parasites, which results in quick relief from clinical symptoms. Its action is based on producing free radicals that damage the malaria parasite.
Mefloquine: It is a quinoline-methanol, structurally related to quinine. Mefloquine disrupts the digestive vacuole of the malarial parasite, leading to the parasite's death. It acts on the remaining parasites in the bloodstream, effectively clearing them.
Benefits of the Combination:
The combination of two drugs with different mechanisms of action reduces the risk of resistance.
Artesunate offers rapid symptomatic relief and reduction of parasite transmission, while mefloquine ensures clearance of any remaining parasites.
Dosage and Administration:
AS-MQ is usually administered once daily for three days. However, in some regimens, mefloquine might be given as a split dose over two days to reduce potential side effects. As always, the exact dosage and duration depend on age, weight, and specific recommendations.
Side Effects:
Artesunate: Generally well-tolerated. Side effects are rare but can include dizziness, nausea, and some blood disorders.
Mefloquine: Known for its neuropsychiatric side effects, which can include dizziness, difficulty sleeping, vivid dreams, and, in rare cases, severe anxiety, paranoia, and hallucinations. Gastrointestinal side effects like nausea, vomiting, and diarrhea might also be present.