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The pharmacokinetics of oral dihydroartemisinin and artesunate in healthy Thai volunteers.

Abstract
The pharmacokinetics of oral dihydroartemisinin (DHA) following the dose of 2 and 4 mg/ kg body weight dihydroartemisinin (Twisinin, T-2 Program, Thailand) and 4 mg/kg body weight oral artesunate (AS; Guilin Pharmaceutical Works, Guangxi, China) were investigated in 20 healthy Thai volunteers (10 males, 10 females). All formulations were generally well tolerated. Oral DHA was rapidly absorbed from gastrointestinal tract with marked inter-individual variation. The pharmacokinetics of DHA following the two dose levels were similar and linearity in its kinetics was observed. Based on the model-independent pharmacokinetic analysis, median (95% CI) values for Cmax of 181 (120-306) and 360 (181-658) ng/ml were achieved at 1.5 hours following 2 and 4 mg/kg body weight dose, respectively. The corresponding values for AUC0-infinity, t1/2z, CL/f and Vz/f were 377 (199-1,128) vs 907 (324-2,289) ng.h/ml, 0.96 (0.70-1.81) vs 1.2 (0.75-1.44) hours, 7.7 (4.3-12.3) vs 6.6 (3.1-10.1) l/kg, and 90.5 (28.6-178.2) vs 6.6 (3.1-10.1) ml/min/kg, respectively (2 vs 4 mg/kg dose). Oral AS was rapidly biotransformed to DHA, which was detectable in plasma as early as 15 minutes of AS dosing. Following 4 mg/kg dose, median (95% CI) value for Cmax of 519 (236-284) ng/ml was achieved at 0.7 (0.25-1.5) hours. AUC0-infinity, and t1/2z were 657 (362-2,079) ng.h/ml, 0.74 (0.34-1.42) hours, respectively. Cmax of DHA following oral AS were significantly higher, but total systemic exposure was greater following oral DHA at the same dose level (4 mg/kg body weight). There was no significant sex difference in pharmacokinetics of DHA.
AuthorsK Na-Bangchang, S Krudsood, U Silachamroon, P Molunto, O Tasanor, K Chalermrut, N Tangpukdee, O Matangkasombut, S Kano, S Looareesuwan
JournalThe Southeast Asian journal of tropical medicine and public health (Southeast Asian J Trop Med Public Health) Vol. 35 Issue 3 Pg. 575-82 (Sep 2004) ISSN: 0125-1562 [Print] Thailand
PMID15689069 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antimalarials
  • Artemisinins
  • Sesquiterpenes
  • artesunate
  • dihydroartemisinin
Topics
  • Administration, Oral
  • Adult
  • Antimalarials (administration & dosage, blood, pharmacokinetics)
  • Area Under Curve
  • Artemisinins (administration & dosage, blood, pharmacokinetics)
  • Biological Availability
  • Cross-Over Studies
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Middle Aged
  • Sesquiterpenes (administration & dosage, blood, pharmacokinetics)
  • Thailand

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