Publication: Pharmacokinetics of dihydroartemisinin following oral artesunate treatment of pregnant women with acute uncomplicated falciparum malaria
Issued Date
2006-05-01
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ISSN
00316970
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2-s2.0-33646536090
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Mahidol University
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SCOPUS
Bibliographic Citation
European Journal of Clinical Pharmacology. Vol.62, No.5 (2006), 367-371
Suggested Citation
R. McGready, K. Stepniewska, S. A. Ward, T. Cho, G. Gilveray, S. Looareesuwan, N. J. White, F. Nosten Pharmacokinetics of dihydroartemisinin following oral artesunate treatment of pregnant women with acute uncomplicated falciparum malaria. European Journal of Clinical Pharmacology. Vol.62, No.5 (2006), 367-371. doi:10.1007/s00228-006-0118-y Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/23763
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Title
Pharmacokinetics of dihydroartemisinin following oral artesunate treatment of pregnant women with acute uncomplicated falciparum malaria
Abstract
Objective: To determine the pharmacokinetic properties of dihydroartemisinin (DHA) following oral artesunate treatment in women with recrudescent multidrug resistant falciparum malaria, in the second and third trimesters of pregnancy. Methods: Serial plasma concentrations of artesunate and DHA were measured in 24 women after the final dose of a 3 day treatment with artesunate (4 mg kg-1day-1) and atovaquone (20 mg kg-1day-1) plus proguanil (8 mg kg-1day-1), daily. Conventional non-compartmental modelling and a population one-compartment pharmacokinetic model were applied to the data. Results: Artesunate was very rapidly eliminated. For DHA the median [90% range] estimate of oral clearance (CI/F) was 4.0 [0.8-20.7] 1 hour-1kg-1, total apparent volume of distribution (Vd/f) was 3.4 [0.9-60.7] l/kg, and terminal elimination half-life was 1.0 [0.6-2.4] h. Conclusion: The kinetics of DHA are modified by pregnancy. The plasma levels of the active antimalarial metabolite DHA are lower than reported previously in non-pregnant adults. Dose-optimisation studies in pregnant women are needed. © Springer-Verlag 2006.