1921
Volume 87, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

The pharmacokinetic properties of piperaquine were investigated in 12 pregnant and 12 well-matched, non-pregnant women receiving a three-day oral fixed dose combination regimen of dihydroartemisinin and piperaquine for treatment of uncomplicated at New Halfa Hospital in eastern Sudan. Frequent venous plasma samples were drawn from the patients over a 63-day period and a complete concentration–time profile was collected for 7 pregnant and 11 non-pregnant patients. Piperaquine was quantified using a liquid chromatography–mass spectrometry/mass spectrometry method. Pregnant women had a significantly higher total drug exposure (median area under the curve [range] = 1,770 [1,200–5,600] hr × ng/mL versus 858 [325–2,370] hr × ng/mL; = 0.018) and longer time to maximal concentration (4.00 [1.50–4.03] hr versus 1.50 [0.500–8.00] hr; = 0.02) after the first dose compared with non-pregnant women. There was no other significant difference observed in piperaquine pharmacokinetics between pregnant and non-pregnant women, including no difference in total drug exposure or maximum concentration. The overall pharmacokinetic properties of piperaquine in this study were consistent with previously published reports in non-pregnant patients.

[open-access] This is an Open Access article distributed under the terms and of the American Society of Tropical Medicine and Hygiene's Re-use License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.2012.11-0410
2012-07-02
2019-06-19
Loading full text...

Full text loading...

/deliver/fulltext/14761645/87/1/35.html?itemId=/content/journals/10.4269/ajtmh.2012.11-0410&mimeType=html&fmt=ahah

References

  1. Dellicour S, Tatem AJ, Guerra CA, Snow RW, ter Kuile FO, , 2010. Quantifying the number of pregnancies at risk of malaria in 2007: a demographic study. PLoS Med 7: e1000221.[Crossref] [Google Scholar]
  2. Elghazali G, Adam I, Hamad A, El-Bashir MI, , 2003. Plasmodium falciparum infection during pregnancy in an unstable transmission area in eastern Sudan. East Mediterr Health J 9: 570580. [Google Scholar]
  3. Luxemburger C, Ricci F, Nosten F, Raimond D, Bathet S, White NJ, , 1997. The epidemiology of severe malaria in an area of low transmission in Thailand. Trans R Soc Trop Med Hyg 91: 256262.[Crossref] [Google Scholar]
  4. Adam I, Babiker S, Mohmmed AA, Salih MM, Prins MH, Zaki ZM, , 2007. ABO blood group system and placental malaria in an area of unstable malaria transmission in eastern Sudan. Malar J 6: 110.[Crossref] [Google Scholar]
  5. Adam I, Khamis AH, Elbashir MI, , 2005. Prevalence and risk factors for anemia in pregnant women of eastern Sudan. Trans R Soc Trop Med Hyg 99: 739743.[Crossref] [Google Scholar]
  6. Adam I, Khamis AH, Elbashir MI, , 2005. Prevalence and risk factors for Plasmodium falciparum malaria in pregnant women of eastern Sudan. Malar J 4: 18.[Crossref] [Google Scholar]
  7. Bader E, Alhaj AM, Hussan AA, Adam I, , 2010. Malaria and stillbirth in Omdurman Maternity Hospital, Sudan. Int J Gynaecol Obstet 109: 144146.[Crossref] [Google Scholar]
  8. Brabin BJ, , 1983. An analysis of malaria in pregnancy in Africa. Bull World Health Organ 61: 10051016. [Google Scholar]
  9. Elhassan EM, Mirghani OA, Adam I, , 2009. High maternal mortality and stillbirth in the Wad Medani Hospital, Central Sudan, 2003–2007. Trop Doct 39: 238239.[Crossref] [Google Scholar]
  10. Haggaz AA, Radi EA, Adam I, , 2007. High maternal mortality in Darfur, Sudan. Int J Gynaecol Obstet 98: 252253.[Crossref] [Google Scholar]
  11. World Health Organization, 2010. Guidelines for the Treatment of Malaria. Geneva: World Health Organization. [Google Scholar]
  12. Adam I, Osman ME, Elghzali G, Ahmed GI, Gustafssons LL, Elbashir MI, , 2004. Efficacies of chloroquine, sulfadoxine-pyrimethamine and quinine in the treatment of uncomplicated, Plasmodium falciparum malaria in eastern Sudan. Ann Trop Med Parasitol 98: 661666.[Crossref] [Google Scholar]
  13. Adam I, Salah MT, Eltahir HG, Elhassan AH, Elmardi KA, Malik EM, , 2010. Dihydroartemisinin-piperaquine versus artemether-lumefantrine, in the treatment of uncomplicated Plasmodium falciparum malaria in central Sudan. Ann Trop Med Parasitol 104: 319326.[Crossref] [Google Scholar]
  14. Ratcliff A, Siswantoro H, Kenangalem E, Maristela R, Wuwung RM, Laihad F, Ebsworth EP, Anstey NM, Tjitra E, Price RN, , 2007. Two fixed-dose artemisinin combinations for drug-resistant falciparum and vivax malaria in Papua, Indonesia: an open-label randomised comparison. Lancet 369: 757765.[Crossref] [Google Scholar]
  15. Loebstein R, Lalkin A, Koren G, , 1997. Pharmacokinetic changes during pregnancy and their clinical relevance. Clin Pharmacokinet 33: 328343.[Crossref] [Google Scholar]
  16. Ohkita C, Goto M, , 1990. Increased 6-hydroxycortisol excretion in pregnant women: implication of drug-metabolizing enzyme induction. DICP 24: 814816. [Google Scholar]
  17. Tarning J, McGready R, Lindegardh N, Ashley EA, Pimanpanarak M, Kamanikom B, Annerberg A, Day NP, Stepniewska K, Singhasivanon P, White NJ, Nosten F, , 2009. Population pharmacokinetics of lumefantrine in pregnant women treated with artemether-lumefantrine for uncomplicated Plasmodium falciparum malaria. Antimicrob Agents Chemother 53: 38373846.[Crossref] [Google Scholar]
  18. Nyunt MM, Adam I, Kayentao K, van Dijk J, Thuma P, Mauff K, Little F, Cassam Y, Guirou E, Traore B, Doumbo O, Sullivan D, Smith P, Barnes KI, , 2010. Pharmacokinetics of sulfadoxine and pyrimethamine in intermittent preventive treatment of malaria in pregnancy. Clin Pharmacol Ther 87: 226234.[Crossref] [Google Scholar]
  19. McGready R, Stepniewska K, Ward SA, Cho T, Gilveray G, Looareesuwan S, White NJ, Nosten F, , 2006. Pharmacokinetics of dihydroartemisinin following oral artesunate treatment of pregnant women with acute uncomplicated falciparum malaria. Eur J Clin Pharmacol 62: 367371.[Crossref] [Google Scholar]
  20. McGready R, Stepniewska K, Edstein MD, Cho T, Gilveray G, Looareesuwan S, White NJ, Nosten F, , 2003. The pharmacokinetics of atovaquone and proguanil in pregnant women with acute falciparum malaria. Eur J Clin Pharmacol 59: 545552.[Crossref] [Google Scholar]
  21. Karunajeewa HA, Salman S, Mueller I, Baiwog F, Gomorrai S, Law I, Page-Sharp M, Rogerson S, Siba P, Ilett KF, Davis TM, , 2010. Pharmacokinetics of chloroquine and monodesethylchloroquine in pregnancy. Antimicrob Agents Chemother 54: 11861192.[Crossref] [Google Scholar]
  22. Karunajeewa HA, Salman S, Mueller I, Baiwog F, Gomorrai S, Law I, Page-Sharp M, Rogerson S, Siba P, Ilett KF, Davis TM, , 2009. Pharmacokinetic properties of sulfadoxine-pyrimethamine in pregnant women. Antimicrob Agents Chemother 53: 43684376.[Crossref] [Google Scholar]
  23. World Health Organization, 2000. Severe falciparum malaria. Trans R Soc Trop Med Hyg 94: 190. [Google Scholar]
  24. Lindegardh N, Annerberg A, White NJ, Day NP, , 2008. Development and validation of a liquid chromatographic-tandem mass spectrometric method for determination of piperaquine in plasma stable isotope labeled internal standard does not always compensate for matrix effects. J Chromatogr B Analyt Technol Biomed Life Sci 862: 227236.[Crossref] [Google Scholar]
  25. Plowe CV, Djimde A, Bouare M, Doumbo O, Wellems TE, , 1995. Pyrimethamine and proguanil resistance-conferring mutations in Plasmodium falciparum dihydrofolate reductase: polymerase chain reaction methods for surveillance in Africa. Am J Trop Med Hyg 52: 565568. [Google Scholar]
  26. Tarning J, Lindegardh N, Annerberg A, Singtoroj T, Day NP, Ashton M, White NJ, , 2005. Pitfalls in estimating piperaquine elimination. Antimicrob Agents Chemother 49: 51275128.[Crossref] [Google Scholar]
  27. Tarning J, Ashley EA, Lindegardh N, Stepniewska K, Phaiphun L, Day NP, McGready R, Ashton M, Nosten F, White NJ, , 2008. Population pharmacokinetics of piperaquine after two different treatment regimens with dihydroartemisinin-piperaquine in patients with Plasmodium falciparum malaria in Thailand. Antimicrob Agents Chemother 52: 10521061.[Crossref] [Google Scholar]
  28. Karunajeewa HA, Ilett KF, Mueller I, Siba P, Law I, Page-Sharp M, Lin E, Lammey J, Batty KT, Davis TM, , 2008. Pharmacokinetics and efficacy of piperaquine and chloroquine in Melanesian children with uncomplicated malaria. Antimicrob Agents Chemother 52: 237243.[Crossref] [Google Scholar]
  29. Hung TY, Davis TM, Ilett KF, Karunajeewa H, Hewitt S, Denis MB, Lim C, Socheat D, , 2004. Population pharmacokinetics of piperaquine in adults and children with uncomplicated falciparum or vivax malaria. Br J Clin Pharmacol 57: 253262.[Crossref] [Google Scholar]
  30. Rijken MJ, McGready R, Boel ME, Barends M, Proux S, Pimanpanarak M, Singhasivanon P, Nosten F, , 2008. Dihydroartemisinin-piperaquine rescue treatment of multidrug-resistant Plasmodium falciparum malaria in pregnancy: a preliminary report. Am J Trop Med Hyg 78: 543545. [Google Scholar]
  31. Poespoprodjo JR, Fobia W, Kenangalem E, Lampah DA, Warikar N, Seal A, McGready R, Sugiarto P, Tjitra E, Anstey NM, Price RN, , 2008. Adverse pregnancy outcomes in an area where multidrug-resistant Plasmodium vivax and Plasmodium falciparum infections are endemic. Clin Infect Dis 46: 13741381.[Crossref] [Google Scholar]
  32. Poespoprodjo JR, Fobia W, Kenangalem E, Hasanuddin A, Sugiarto P, Tjitra E, Anstey NM, Price RN, , 2011. Highly effective therapy for maternal malaria associated with a lower risk of vertical transmission. J Infect Dis 204: 16131619.[Crossref] [Google Scholar]
  33. Batty KT, Moore BR, Stirling V, Ilett KF, Page-Sharp M, Shilkin KB, Mueller I, Rogerson SJ, Karunajeewa HA, Davis TM, , 2010. Investigation of reproductive toxicity of piperaquine in mice. Reprod Toxicol 29: 206213.[Crossref] [Google Scholar]
  34. Morris CA, Onyamboko MA, Capparelli E, Koch MA, Atibu J, Lokomba V, Douoguih M, Hemingway-Foday J, Wesche D, Ryder RW, Bose C, Wright L, Tshefu AK, Meshnick S, Fleckenstein L, , 2011. Population pharmacokinetics of artesunate and dihydroartemisinin in pregnant and non-pregnant women with malaria. Malar J 10: 114.[Crossref] [Google Scholar]
  35. Tarning J, Rijken MJ, McGready R, Phyo AP, Hanpithakpong W, Day NP, White NJ, Nosten F, Lindegardh N, , 2012. Population pharmacokinetics of dihydroartemisinin and piperaquine in pregnant and nonpregnant women with uncomplicated malaria. Antimicrob Agents Chemother 56: 19972007.[Crossref] [Google Scholar]
  36. Roshammar D, Hai TN, Friberg Hietala S, Van Huong N, Ashton M, , 2006. Pharmacokinetics of piperaquine after repeated oral administration of the antimalarial combination CV8 in 12 healthy male subjects. Eur J Clin Pharmacol 62: 335341.[Crossref] [Google Scholar]
  37. Sim IK, Davis TM, Ilett KF, , 2005. Effects of a high-fat meal on the relative oral bioavailability of piperaquine. Antimicrob Agents Chemother 49: 24072411.[Crossref] [Google Scholar]
  38. Nguyen TC, Nguyen NQ, Nguyen XT, Bui D, Travers T, Edstein MD, , 2008. Pharmacokinetics of the antimalarial drug piperaquine in healthy Vietnamese subjects. Am J Trop Med Hyg 79: 620623. [Google Scholar]
  39. Chinh NT, Quang NN, Thanh NX, Dai B, Geue JP, Addison RS, Travers T, Edstein MD, , 2009. Pharmacokinetics and bioequivalence evaluation of two fixed-dose tablet formulations of dihydroartemisinin and piperaquine in Vietnamese subjects. Antimicrob Agents Chemother 53: 828831.[Crossref] [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2012.11-0410
Loading
/content/journals/10.4269/ajtmh.2012.11-0410
Loading

Data & Media loading...

  • Received : 26 Jun 2011
  • Accepted : 31 Mar 2012
  • Published online : 02 Jul 2012

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error