Antimalarial

Product Details:

Indications:              

• P.falciparum malaria especially in quinidine-resistant patients.

Dosage:

• Adults and children over 6 months: 5 mg/kg orally on the first day followed by 2.5 mg/kg on the second and third days in combination with mefloquine (15 mg/kg) in a single dose on the second day. In a few areas, a higher dose (25 mg/kg) of mefloquine may be required for a cure to be obtained.

Product Details:

Indications:  

• Chloroquine resistant malaria,
• Complicated falciparam malaria
• Cerebral malaria.

Dosage:

• Adult: Due to Plasmodium falciparum: 150 mg once daily for 3 consecutive days.
• Children - 3mg/Kg per day administered by intramuscular injection over a 3-day period.

Product Details:

Indications:              

• Artesunate has an antimalrial activity.
• It can quickly and reliably control the actute attack and cerebral type of malaria. It is effective against plasmodium falciparum and plasmodium vivax, especially against malaria parasites resistant to Chlorquine. falciparum malaria.

Dosage:

• Adult & Child: 2.4 mg/kg via IM or IV admin. Repeat 12 hr and 24 hr later, then once daily thereafter.

The usual injection dosage for each time:

• Adult and Children >
• 7 years: 1.2mg/kg.
• Children < 7 years: 1.5mg/kg.

The following doses are given at hour 4 and 24 after the first injection in day 1. Give 1 dose daily for the consecutive days. A course of therapy is recommended for 5 consecutive days.

Product Details:

Indications:   

• Atovaquone/Proguanil Hydrochloride is a fixed dose combination of atovaquone and proguanil hydrochloride which acts as a blood schizonticide and also has activity against hepatic schizonts of Plasmodium falciparum. It is indicated for:
• Prophylaxis of Plasmodium falciparum malaria.
• Treatment of acute, uncomplicated Plasmodium falciparum malaria.
• Because Atovaquone/Proguanil Hydrochloride is effective against drug sensitive and drug resistant P. falciparum it is especially recommended for prophylaxis and treatment of P. falciparum malaria where the pathogen may be resistant to other antimalarials.

Dosage:

Prophylaxis:

• Commence 24 or 48 hours prior to entering a malaria-endemic area
• Continue during the period of the stay
• Continue for 7 days after leaving the area
• In residents (semi-immune subjects) of endemic areas, the safety and effectiveness of Atovaquone/Proguanil Hydrochloride has been established in studies of up to 12 weeks.
• In non-immune subjects, the average duration of exposure in clinical studies was 27 days.

Dosage in Adults:

• One Atovaquone/Proguanil Hydrochloride film-coated tablet daily.
• Atovaquone/Proguanil Hydrochloride is not recommended for malaria prophylaxis in persons under 40 kg bodyweight. Other pharmaceutical strengths may be more appropriate for malaria prophylaxis in persons weighing under 40 kg.

Treatment:

Adults:

• Four Atovaquone/Proguanil Hydrochloride film-coated tablets as a single dose for three consecutive days.

Elderly:

• A pharmacokinetic study indicates that no dosage adjustments are needed in the elderly

Hepatic Impairment:

• A pharmacokinetic study indicates that no dosage adjustments are needed in patients with mild to moderate hepatic impairment. Although no studies have been conducted in patients with severe hepatic impairment.

Renal Impairment:

• Pharmacokinetic studies indicate that no dosage adjustments are needed in patients with mild to moderate renal impairment. In patients with severe renal impairment (creatine clearance <30 mL/min) alternatives to Atovaquone/Proguanil Hydrochloride for treatment of acute P. falciparum malaria should be recommended whenever possible.

Method of administration:

• The daily dose should be taken with food or a milky drink (to ensure maximum absorption of Atovaquone) at the same time each day.
• If patients are unable to tolerate food, Atovaquone/Proguanil Hydrochloride should be administered, but systemic exposure of atovaquone will be reduced.

Children: 

Product Details:

Indications:              

• Rheumatoid arthritis
• Discoid and systemic lupus erythematosus
• Prophylaxis of malaria
• Acute malaria

Dosage:

Rheumatoid arthritis; Discoid and systemic lupus erythematosus:

• Adult: Initially, 400 mg daily as single or in 2 divided doses. Maintenance: 200-400 mg daily, according to response. Max: 6.5 mg/kg/day or 400 mg daily, whichever is lower.
• Child: Up to 6.5 mg/kg daily or 400 mg daily, whichever is lower.

Prophylaxis of malaria:

• Adult: Initially, 400 mg once wkly, 2 wk before exposure and continued until 8 wk after exposure. Alternatively, if 2-wk lead-in period is not possible, 800 mg as loading dose in 2 divided doses 6 hr apart, then 400 mg once wkly continued until 8 wk after exposure. All doses should be taken on same day of each wk.
• Child: 6.5 mg/kg once wkly, 2 wk before exposure and continued until 8 wk after exposure. Alternatively, if 2-wk lead-in period is not possible, 13 mg/kg as loading dose in 2 divided doses 6 hr apart, then once wkly treatment for 8 wk after exposure. All doses should be taken on same day of each wk.

Acute malaria:

• Adult: Initially, 800 mg, then 400 mg after 6-8 hr and a further 400 mg once daily for 2 succeeding days. Alternatively, 800 mg as single dose.
• Child: Initially, 13 mg/kg as single dose then 6.5 mg/kg after 6, 24 and 48 hr.

Product Details:

Indications:              

• Proguanil Hydrochloride is an effective antimalarial agent. It is recommended for the prevention and suppression of malaria.

Dosage:

• Non-immune subjects entering a malarious area are advised to begin treatment with Paludrine 1 week before, or if this is not possible, then at least 2 days before entering the malarious area. The daily dose of Paludrine should be continued throughout exposure to risk and for 4 weeks after leaving the area.

Adults:

• Two tablets (200 mg) daily.

Paediatric population:

• Under 1 year:    1/4 tablet (25 mg) daily
• 1 to 4 years:    1/2 tablet (50 mg) daily
• 5 to 8 years:    1 tablet (100 mg) daily
• 9 to 14 years:    1 1/2 tablets (150 mg) daily
• Over 14 years:    Adult dose daily

The daily dose is best taken with water, after food, at the same time each day.
Provided the tablet fragment gives the minimum amount specified, precise accuracy in children's dosage is not essential since the drug possesses a wide safety margin.

For a young child, the dose may be administered crushed and mixed with milk, honey or jam.

Older people: There are no special dosage recommendations for the elderly, but it may be advisable to monitor elderly patients so that optimum dosage can be individually determined.

Renal Impairment: Based on a theoretical model derived from a single dose pharmacokinetic study, the following guidance is given for adults with renal impairment.