Clinical medicine profile
Pyronaridine/artesunate
Antimalarial
- Route
- ORAL / PARENTERAL (severe malaria)
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Known hypersensitivity.
- Agent-specific: e.g. mefloquine in active depression/psychosis/seizure disorder
- primaquine in G6PD deficiency (haemolysis).
- Always check agent-specific absolute contraindications.
Precautions
- Confirm species and severity.
- ECG risk with some agents (quinine, piperaquine).
- Pregnancy: follow Kenya/WHO trimester-specific ACT guidance.
- Vomiting within 30–60 min may need redosing per protocol.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
Dosage in adults and children: Wt 15 - < 24 kg: 1 tab D OD x 3/7. Wt. 24 - <45 kg 2 tab OD x 3/7. Wt. 45 - < 65kg: 3 tabs OD x 3/7. Wt. 65 kg 4 tabs OD x 3/7. Dosage in children and infants: BW: 5 - < 8 kg 1 sachet OD x3/7. Wt. 8 - < 15 kg: 2 sachets OD x 3/7. Wt. 15 - < 20 kg 3 sachets OD x 3/7. Wt. 20 - < 25 kg 4 OD x 3/7.
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Supportive care critical in severe malaria; adjust supportive drugs as needed.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Monitor if pre-existing liver disease; many agents hepatically metabolised.
Use, effects & interactions
Indications
- Blood-stage treatment ofP. falciparumandP. vivax especially in areas where other ACTs are failing.
- Clinical selection for Pyronaridine/artesunate should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Antimalarial.
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- GI upset, headache, dizziness, sleep disturbance (mefloquine).
- Serious: cardiotoxicity, neuropsychiatric effects, haemolysis (primaquine in G6PD def.), cinchonism (quinine).
Drug interactions
Open multi-drug checker ↗- Fixed-dose/multi-ingredient product.
- Clinical details partially inherited from component monographs: Artesunate Sodium/Amodiaquine.
- Confirm combination SmPC for exact dosing.
Mechanism & disposition
Artesunate is believed that iron from ingested hemoglobin of the parasites victim reduces endoperoxide bridge releasing a highly reactive free radical iron [IV] oxo species that rips apart the parasitic cells.
Read complete mechanism
Artesunate is believed that iron from ingested hemoglobin of the parasites victim reduces endoperoxide bridge releasing a highly reactive free radical iron [IV] oxo species that rips apart the parasitic cells. Pyronaridine is a hydroxyanilino-benzonaphthyridine acridine derivative which also includes amodiaquine-like side chain. Pyronaridine inhibits -haematin production and forms complexes with haematin to enhance haematin-induced human blood cell lysis and to inhibit glutathione-dependent degradation of haematin
Hours (artemisinins rapid parasite clearance)
Regimen-dependent (ACT 3 days typical)
ORAL / PARENTERAL (severe malaria)
enhanced by fat-containing food. Complex
(CYP3A4) for several partners. Severe malaria: parenteral artesunate preferred first-line in most guidelines.
Pregnancy, lactation & diet
[Pyronaridine] Treat malaria — untreated infection risks mother and fetus. Use trimester-appropriate regimens per Kenya MoH / WHO. [artesunate] [Artesunate] Treat malaria — untreated infection risks mother and fetus. Use trimester-appropriate regimens per Kenya MoH / WHO. [Mefloquine] Treat malaria — untreated infection risks mother and fetus. Use trimester-appropriate regimens per Kenya MoH / WHO.
[Pyronaridine] Most first-line ACTs compatible; continue breastfeeding with maternal treatment. [artesunate] [Artesunate] Most first-line ACTs compatible; continue breastfeeding with maternal treatment. [Mefloquine] Most first-line ACTs compatible; continue breastfeeding with maternal treatment.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.