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Drugs Used In Malaria For Its Treatment

Combination Drugs

Artesunate (Falcigo), Artemether (Paluther), Arteether (E-mail)

These drugs originate from a Chinese plant and are effective in cerebral malaria and in chloroquine-resistant falciparum malaria. These drugs are potent and rapid-acting and their use is increasing.

Dosage: Artesunate is given in a dose of 100 mg twice a day on the first day, then 100 mg once a day for 4 days orally. Artemether in given intramuscularly 80 mg, twice a day on the first day, then 80 mg once a day for 4 days. Arteether is given intramuscularly 150 gm, once a day for 3 days.

Adverse Effects: Bowel disturbance, irregularity of heart, fall in white blood cell count and abdominal pain have been reported. One should avoid drugs which aggravate these changes on heart-rhythm. These should not be used for prevention of malaria.

Combination Drugs

Pyrimethamine+Sulfadoxine (Malocide, Reziz, Malaprim), Pyrimethamine+ Sulfamethoxypyrazine (Metakelfin)

These combinations are used both for prophylaxis and treatment of chloroquin resistant malaria. For the treatment of an acute attack, 2 to 3 tablets (each tablet contains 25 mg pyrimethmine + 500 mg of sulfadoxine) are taken as a single dose. Those patients who are allergic to 'sulfa' drugs should not take these. Similarly these should not be used in infants. Nowadays falciparum parasites have developed resistance to these combination also.

Malaria while Travelling

Malaria can be prevented by chloroquin phosphate 500 mg (250 mg x 2 tab) to be taken once a week, starting from the time of entering the infected region and for 4 weeks after entering the infected region, continued for 4 weeks after leaving. If resistance is reported, mefloquin 250 mg tablet is taken as above. If it is not tolerated then doxycyline 100 mg in a day for 2 days before entering the region, continued while staying there, and for 4 weeks after leaving should be taken.