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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