Dihydroartemisinin

Dihydroartemisinin or DHA is a semi-synthetic derivative of artemisinin. It is used primarily in the preparation of Artemisinin-derived antimalarial drugs. It cures malaria. While Dihydroartemisinin is the active metabolite in artemisinin compounds it is also sold as a drug in itself. Commercially, it is sold with piperaquine. It has been shown to be similar to Artemether or Lumefantrine. Dihydroartemisinin in combination with piperaquine is sold as Eurartesim and Artekin among several other brands. Hoechst Aktiengesellschaft filed the first patent in 1987, this was followed by a patent filing in the USA by Thornfeldt Carl R in 1987. In 2018, WHO says, worldwide malaria-affected 228 million people, resulting in 405,000 deaths. The key to the treatment is timely intervention before it turns severe and then fatal.

Dosage and forms

Dihydroartemisinin is sold as tablets and injections. In the cases of acute malaria, the initial the recommended adult dose is 120 mg, and this is followed by a maintenance dose of 60 mg, taken daily for another 4 to 6 days.

The cost of Dihydroartemisinin

In India and elsewhere in the developing world this medicine is very cheap. In most countries, a tablet of 200 mg costs less than a cent. The oral suspension costs around USD1 for an 80ml solution.

How does Dihydroartemisinin Work?

Apicomplexans cause Malaria. Plasmodium falciparum residing in red blood cells and contains iron-rich heme-groups. Dihydroartemisinin binds to a large number targets a broad spectrum of proteins in the human cancer cell proteome through heme-activated radical alkylation. Dihydroartemisinin actions cleavage endoperoxide bridges by iron. It does this producing free radicals like hypervalent iron-oxo species, epoxides, aldehydes, and dicarbonyl compounds. These damage biological macromolecules causing oxidative stress in the cells of the parasite. Its production of free radicals, reactive metabolites, and altered membrane transport properties of membranes stop the nutrient flow to the parasite. It is Active against all human malarial parasites, including even the multi-drug resistant Plasmodium falciparum strains.

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