DƯỢC LÍ Goodman & Gilman's The Pharmacological Basis of Therapeutics 12th, 2010

Table 49–3
Regimens for the Treatment of Malaria
POTENTIAL ADVERSE
DRUG INDICATION ADULT DOSAGE PEDIATRIC DOSAGE a EFFECTS COMMENTS
Artemether- P. falciparum Tablet: Wt. Tablets Adults; headache Take with food or
lumefantrine from 20 mg artemether, (kg) (per dose) anorexia, dizziness, whole milk. If patient vomits
(COARTEM) chloroquine limefantrine. 5-15 1 asthenia, arthralgia within 30 minutes, repeat dose.
resistant or Dose: 4 tablets 15-25 2 myalgia Contraindicated in pregnancy
unknown Day 1: 2 doses 25-<35 3 Children: fever,
areas separated by 8 hours; >35 4 cough, vomiting,
thereafter bid × 2d Use same 3-day loss of appetite,
schedule as adluts
headache
Artesunate Severe malaria U.S. treatment IND See Artemether See Artemether and CDC guidelines
(IV; available (see CDC (CDC): 4 equal doses
from U.S. guidelines) of artesunate
Center for
(2.4 mg/kg each)
Disease Control
and Prevention)
over a 3-day period
followed by oral
treatment with
atovaquone-proguanil,
doxycycline,
clindamycin, or
mefloquine (to avoid
emergence of
resistance)
Atovaquone- Plasmodium Adult tablet 250 mg Pediatric tablet = 62.5 mg Abdominal pain, Not indicated for use in pregnant
proguanil falciparum atovaquone/100 mg, atovaquone/25 mg nausea, vomiting, women due to limited data
MALARONE from chloroquine- proguanil proguanil diarrhea, headache, Contraindicated if hypersensitivity
(oral) resistant areas; 4 Adult tablets 5-8 kg: 2 ped tab rash, mild reversible to atovaquone or proguanil; severe
can be used for orally per day × 3 d orally per day × 3 d elevations in liver renal impairment (creatinine
P. vivax >8-10 kg: 3 ped tab orally aminotransferase clearance <30 mL/min)
daily × 3 d levels Should be taken with food to
>10-20 kg: 1 adult tab increase absorption of atovaquone
orally daily × 3 d
>20-30 kg: 2 adult tab
orally daily × 3 d
>30-40 kg: 3 adult
tab orally daily × 3 d
>40 kg: 4 adult tab
orally daily × 3 d
(Continued)