Side effects are uncommon.[4] Concerns include the possibility of QT prolongation.[4] Versions are available for use in children.[3] Use in early pregnancy is not recommended.[4] The two medications work by different mechanisms.[4]
Piperaquine/dihydroartemisinin was approved for medical use in Europe in 2011.[3] The combination is on the World Health Organization's List of Essential Medicines.[2][5] It is commercially available in Africa and Asia.[3] It has been used to treat more than 4.5million people as of 2017.[3]
Dihydroartemisinin (also known as dihydroqinghaosu, artenimol or DHA) is a drug used to treat malaria. Dihydroartemisinin is the active metabolite of all artemisinin compounds (artemisinin, artesunate, artemether, etc.) and is also available as a drug in itself. It is a semi-synthetic derivative of artemisinin and is widely used as an intermediate in the preparation of other artemisinin-derived antimalarial drugs.
Piperaquine is an antimalarial drug, a bisquinoline first made in the 1960s, and used extensively in China and Indochina as prophylaxis and treatment during the next 20 years. Usage declined in the 1980s as piperaquine-resistant strains of P. falciparum arose and artemisinin-based antimalarials became available. The combination dihydroartemisinin-piperaquine is an effective antimalarial that is used widely around the world. In South-East Asia, where resistance has emerged towards both artemisinin and piperaquine, the combination is being trialed with a third drug, namely mefloquine.[6]
Piperaquine is characterized by slow absorption and a long biological half-life, making it a good partner drug with artemisinin derivatives which are fast acting but have a short biological half-life.
^ abcWorld 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.
^World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
