Drug-Resistant Malaria - libdoc.who.int - World Health Organization

APPENDICES / 117
Note: A fixed combination of sulfalene 500 mg and pyrimethamine 25
mg is available under the trade name Metakelfin. Its cost,
regimen, efficacy and tolerance may be similar to the combination
of sulfadoxine plus pyrimethamine. It is available ~n tablets
(500 mg + 25 mg) and suspension (200 mg + 10 mg per ml).
1.5 Tetracycline
4-dimethylamino-l,4,4a,S,Sa,6,11,12a-octahydro-3,6,lO,12,12a-pe
ntahydroxy-6- methyl-l,ll-dioxo-2-naphthacenecarboxamide
Trade names:
HCl salts Achromycin, Agromicina, Ambramicina,
Bristacycline, Cyclapar, Cyc lomycin , Hostacyclin,
Omegamycin, Panmycin, Polycycline, Purocyclina, Robitet,
Sanclomycin, Sumycin, Tetra-Bid, Tetrabon, Tetracap,
Tetrachel, Tetracyn, Tetradecin, Tetralan, Tetram
Formulations available -
Tablets or capsules of 500 mg,
250 mg, 100 mg; syrup of 125 mg/S ml
Regimen:
Adults 1-2 g per day in 4 equal doses for 7-10 days
Children (over 8 years) -
for 7-10 days
25-50 mg/kg in 2-4 equal doses
Tetracycline has been shown to have blood schizontocidal
activity in man. Its activity against an established infection
with P.falciparum is, however, too slow and should never be relied
upon alone. For that reason, it is generally used in combination
with conventional doses of quinine for at least the first three
days of therapy. Because of the widespread use of tetracyclines
for many various infections numerous side effects have been
reported. When used in children less than 8 years old tetracyclines
may cause permanent discoloration of teeth and hypoplasia
of enamel. Impaired bone growth may a Iso occur in very young
children. For these reasons tet racyc lines should not be used in
young children or pregnant women. Gastronintestinal intolerance
is not uncommon including nausea, vom1t1ng, abdominal pain and
diarrhoea. Less conunonly oesophageal ulceration and pseudomembranous
colitis have been reported. When used in high doses or in
patients with impaired renal function, liver toxic ity may occur.
Outdated tet racyc line should never be used because it is
nephrotoxic.
Infrequent reactions include fever, urticaria, pseudotumor
cerebri, headache, impaired vision, vertigo, haemolytic anaemia,
leukopenia and phototoxicity.