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

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 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

It has also been studied as a potential anticancer drug,[5] treatment for Ebola[6]

The combination of pyronaridin and altesunate is being studied as a possible treatment for moderate to severe SARS-COV-2.[7]

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 J, Hine P (January 2019). "Pyronaridine-artesunate for treating uncomplicated Plasmodium falciparum malaria". The Cochrane Database of Systematic Reviews. 1: CD006404. doi:10.1002/14651858.CD006404.pub3. PMC 6353203. PMID 30620055.
  5. Villanueva PJ, Martinez A, Baca ST, DeJesus RE, Larragoity M, Contreras L, et al. (2018-11-05). "Pyronaridine exerts potent cytotoxicity on human breast and hematological cancer cells through induction of apoptosis". PloS One. 13 (11): e0206467. doi:10.1371/journal.pone.0206467. PMC 6218039. PMID 30395606.
  6. Lane TR, Massey C, Comer JE, Anantpadma M, Freundlich JS, Davey RA, et al. (November 2019). "Repurposing the antimalarial pyronaridine tetraphosphate to protect against Ebola virus infection". PLoS Neglected Tropical Diseases. 13 (11): e0007890. doi:10.1371/journal.pntd.0007890. PMC 6894882. PMID 31751347.
  7. Krishna, Sanjeev; Augustin, Yolanda; Wang, Jigang; Xu, Chengchao; Staines, Henry M.; Platteeuw, Hans; Kamarulzaman, Adeeba; Sall, Amadou; Kremsner, Peter (2021-01-19). "Repurposing Antimalarials to Tackle the COVID-19 Pandemic: (Trends in Parasitology 37, 8–11; 2021)". Trends in Parasitology. 0 (0). doi:10.1016/j.pt.2020.12.009. ISSN 1471-4922.
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