artesunatemefloquine

Artesunatemefloquine, commonly referred to as artesunate–mefloquine, is a fixed‑dose oral antimalarial medicine that combines artesunate, a fast‑acting artemisinin derivative, with mefloquine, a longer‑acting quinoline methanol compound. The preparation is designed to provide rapid parasite clearance while maintaining longer‑term activity to prevent recrudescence.

Mechanism and activity: Artesunate rapidly kills asexual blood-stage Plasmodium parasites by producing reactive metabolites after activation in the parasite, producing quick reductions in parasite biomass. Mefloquine acts on later stages of the parasite life cycle and, because it remains in the body longer, helps prevent relapse and reinfection after initial clearance. The fixed combination aims to achieve both rapid symptom relief and sustained antimalarial effect, while reducing the risk of resistance from monotherapy.

Uses and administration: Artesunate–mefloquine is used for the treatment of uncomplicated Plasmodium falciparum malaria in people for whom this regimen is appropriate, particularly in areas with chloroquine resistance or multidrug resistance. It is typically given as a fixed-dose tablet taken once daily for a short course (commonly three days), with the exact dose guided by weight and local guidelines. The formulation is designed to simplify treatment and support adherence.

Safety and precautions: Common adverse effects include gastrointestinal symptoms, dizziness, and sleep disturbance. Mefloquine can cause neuropsychiatric effects in some individuals, and patients should be monitored for mood changes or anxiety. Safety considerations in pregnancy and in patients with certain neurological or cardiac conditions require medical guidance and localization of practice guidelines.

Resistance and regulation: Resistance to both artesunate and mefloquine has been reported in some regions, underscoring the importance of appropriate use and surveillance. World Health Organization guidelines endorse ACTs, including artesunate–mefloquine where indicated, as first‑line therapy for uncomplicated P. falciparum malaria in many endemic areas. Availability varies by country.