Artesunate/pyronaridine explained

Artesunate/pyronaridine, sold under the brand name Pyramax, is a fixed-dose combination medication for the treatment of malaria. It can be used for malaria of both the P. falciparum and P. vivax types. It combines artesunate and pyronaridine. It is taken by mouth.[1]

The combination is generally well tolerated.[2] Side effects may include headache, vomiting, or cough.[2] Use in those with severe liver disease or kidney disease is not recommended.[1] Use is not generally recommended in early pregnancy.[1] However, there are no other options and if treatment may save the mother's life it may be used.[1] The two components work by different mechanisms.[1]

It is on the World Health Organization's List of Essential Medicines.[3]

Medical uses

Artesunate/pyronaridine is used for malaria of both the P. falciparum and P. vivax types.[2] It is not recommended for severe disease.[1]

A 2019 review (updated in 2021) found that the combination compared well to artemether/lumefantrine.[4] Benefits also appear similar to mefloquine together with artesunate. It is not recommended for the prevention of malaria.[1]

Research for drug repurposing

There is some in vitro evidence that suggests artesunate/pyronaridine may be worthy of clinical trial study to determine whether it might have a role as a drug for COVID-19 treatment.[5]

Notes and References

  1. Web site: Pyramax 180 mg/60 mg Film-coated tablet. EMA. 13 December 2017. 14 December 2017. https://web.archive.org/web/20171214014547/http://www.ema.europa.eu/docs/en_GB/document_library/Medicine_for_use_outside_EU/2012/06/WC500129288.pdf. dead.
  2. Web site: Application for inclusion in the WHO Model List of essential medicines. WHO. 29 June 2017. Nov 2010.
  3. Book: ((World Health Organization)) . World Health Organization model list of essential medicines: 21st list 2019 . 2019 . 10665/325771 . World Health Organization . World Health Organization . Geneva . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO . free .
  4. Pryce J, Taylor M, Fox T, Hine P . Pyronaridine-artesunate for treating uncomplicated Plasmodium falciparum malaria . The Cochrane Database of Systematic Reviews . 2022 . 6 . CD006404 . June 2022 . 35726133 . 9209011 . 10.1002/14651858.CD006404.pub4 .
  5. Krishna S, Augustin Y, Wang J, Xu C, Staines HM, Platteeuw H, Kamarulzaman A, Sall A, Kremsner P . 6 . Repurposing Antimalarials to Tackle the COVID-19 Pandemic . Trends in Parasitology . 37 . 1 . 8–11 . January 2021 . 33153922 . 7572038 . 10.1016/j.pt.2020.10.003 .