Publication: The pharmacokinetics of artemether and lumefantrine in pregnant women with uncomplicated falciparum malaria
Issued Date
2006-12-01
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ISSN
00316970
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2-s2.0-33751253121
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Mahidol University
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SCOPUS
Bibliographic Citation
European Journal of Clinical Pharmacology. Vol.62, No.12 (2006), 1021-1031
Suggested Citation
Rose McGready, Kasia Stepniewska, Niklas Lindegardh, Elizabeth A. Ashley, Yar La, Pratap Singhasivanon, Nicholas J. White, François Nosten The pharmacokinetics of artemether and lumefantrine in pregnant women with uncomplicated falciparum malaria. European Journal of Clinical Pharmacology. Vol.62, No.12 (2006), 1021-1031. doi:10.1007/s00228-006-0199-7 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/23459
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Title
The pharmacokinetics of artemether and lumefantrine in pregnant women with uncomplicated falciparum malaria
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Abstract
Objective: To determine the pharmacokinetic properties of artemether and lumefantrine (AL) in pregnant women with recrudescent uncomplicated multi-drug resistant falciparum malaria. Methods: Pregnant women who had recurrence of parasitaemia following 7 days supervised quinine treatment were treated with AL. Serial blood samples were taken over a 7-day period, and pharmacokinetic parameters were estimated. For lumefantrine, these data were compared in a population pharmacokinetic model with data from non-pregnant, mainly male adults with acute malaria. Results: The pregnant women (five in the second trimester and eight in the third trimester) had lower concentrations of artemether, dihydroartemisinin and lumefantrine, and the elimination of lumefantrine in pregnant women was more rapid than reported previously in non-pregnant adults. Conclusion: Pregnancy is associated with reduced plasma concentrations of both artemether and lumefantrine. This is likely to be of therapeutic significance as plasma concentrations of lumefantrine, after elimination of artemether, are an important determinant of cure. Further studies are needed to determine the optimum dose regimen of artemether-lumefantrine in pregnancy. © 2006 Springer-Verlag.