QUESTION

What are the of different types of antimalaria drugs?

ANSWER

Most drugs used in treatment are active against the parasite forms in the blood (the form that causes disease) and include:

• chloroquine
• atovaquone-proguanil (Malarone®)
• artemether-lumefantrine (Coartem®)
• artesunate-pyronaridine (Pyramax®)
• dihydroartemisinin-piperaquine (Duo-Cotecxin®)
• mefloquine (Lariam®)
• quinine (given intravenously, this is recommended first-line treatment for severe, complicated malaria)
• quinidine
• doxycycline (used in combination with quinine)
• clindamycin (used in combination with quinine)

All of the treatments above which combine an artemisinin-derivative (such as artemether, artesunate or dihydroartemisinin) in combination with another anti-malarial are called the artemisinin-based combination therapies (ACTs) and are collectively recommended by the World Health Organisation as the first line medication against uncomplicated malaria.

In addition, primaquine is active against the dormant parasite liver forms (hypnozoites) and prevents relapses. Primaquine should not be taken by pregnant women or by people who are deficient in G6PD (glucose-6-phosphate dehydrogenase). Patients should not take primaquine until a screening test has excluded G6PD deficiency.