DIHYDROARTEMISININ/PIPERAQUINE = DHA/PPQ oral

Prescription under medical supervision


Therapeutic action

– Antimalarial

Indications

– Treatment of uncomplicated falciparum malaria
– Treatment of uncomplicated malaria due to other Plasmodium species, when chloroquine cannot be used
– Completion treatment following parenteral therapy for severe malaria

Forms and strengths

– Co-formulated tablets of dihydroartemisinin (DHA)/piperaquine (PPQ), in blister pack, for a complete treatment for one individual

– There are 5 different blister packs:
• 20 mg DHA/160 mg PPQ tablets   blister pack of 3 tablets
• 40 mg DHA/320 mg PPQ tablets   blister pack of 3 tablets
• 40 mg DHA/320 mg PPQ tablets   blister pack of 6 tablets
• 40 mg DHA/320 mg PPQ tablets   blister pack of 9 tablets
• 40 mg DHA/320 mg PPQ tablets   blister pack of 12 tablets

Dosage and duration

– Child 5 to < 25 kg: 2.5 to 10 mg/kg daily of DHA + 20 to 32 mg/kg daily of PPQ
– Child 25 kg and over and adult: 2 to 10 mg/kg daily of DHA + 16 to 27 mg/kg daily of PPQ

Weight

20 mg/160 mg tablet

40 mg/320 mg tablet

5 to < 8 kg

1 tab

8 to < 11 kg

1½ tab

11 to < 17 kg

1 tab

17 to < 25 kg

1½ tab

25 to < 36 kg

2 tab

36 to < 60 kg

3 tab

60 to < 80 kg

4 tab

≥ 80 kg

5 tab

– Tablets are to be taken once daily for 3 days.

Contra-indications, adverse effects, precautions

Do not administer in the event of cardiac disorders (bradycardia, heart rhythm disorders, congestive heart failure).
– Do not combine with drugs that prolong the QT interval: amiodarone, other antimalarials, antipsychotics, fluconazole, fluoroquinolones, hydroxyzine, macrolides, ondansetron, etc.
– Administer with caution to patients > 60 years or with renal or hepatic impairment.
– May cause: cardiac disorders (QT prolongation, tachycardia); rarely, gastrointestinal disturbances, pruritus, hepatic disorders, joint and muscle pain.
– Monitor combination with: antiretrovirals (increased blood levels of these drugs), enzymes inducers such as rifampicin, carbamazepine, phenytoin, phenobarbital (reduced blood levels of DHA/PPQ).
– If the patient vomits within 30 minutes after administration, re-administer the full dose. 
If the patient vomits between 30 minutes and 1 hour after administration, re-administer half of the dose.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication

Remarks

Take 3 hours before or after meals, with a glass of water.
– The tablets may be crushed and mixed with water.
Storage: below 25 °C  -