Artesunate/pyronaridine

Artesunate/pyronaridine, sold under the brand name Pyramax, is a fixed-dose combination medication for the treatment of malaria.[3][1] It can be used for malaria of both the P. falciparum and P. vivax types.[1] It combines artesunate and pyronaridine.[3] It is taken by mouth.[2]

Artesunate/pyronaridine
Combination of
ArtesunateAntimalarial
PyronaridineAntimalarial
Clinical data
Trade namesPyramax[1]
Other namesArtesunate/pyronaridine tetraphosphate[1]
Routes of
administration		By mouth[2]
ATC code
Identifiers
CAS Number

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

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.[1] It is not recommended for severe disease.[2]

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.[4] It is not recommended for the prevention of malaria.[2]

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]

References
  1. "Application for inclusion in the WHO Model List of essential medicines" (PDF). WHO. Nov 2010. Retrieved 29 June 2017.
  2. "Pyramax 180 mg/60 mg Film-coated tablet" (PDF). EMA. Retrieved 13 December 2017.
  3. World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  4. Pryce, Joseph; Taylor, Melissa; Fox, Tilly; Hine, Paul (2022-06-21). "Pyronaridine-artesunate for treating uncomplicated Plasmodium falciparum malaria". The Cochrane Database of Systematic Reviews. 6: CD006404. doi:10.1002/14651858.CD006404.pub4. ISSN 1469-493X. PMC 9209011. PMID 35726133.
  5. Krishna S, Augustin Y, Wang J, Xu C, Staines HM, Platteeuw H, Kamarulzaman A, Sall A, Kremsner P (January 2021). "Repurposing Antimalarials to Tackle the COVID-19 Pandemic". Trends Parasitol. 37 (1): 8–11. doi:10.1016/j.pt.2020.10.003. PMC 7572038. PMID 33153922.
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