INDICES> Dosage of anti-malaria drugs

["pme" <pme@ebonet.net>]

Dosage of anti-malaria drugs.

I would like to bring up the dosage recommendations for some of the anti-malaria drugs.

Why do the dosage recommendations for some anti-malaria drugs stop 
at the body weight (bw) of  60 kg?
This applies for at least two of the still most used anti-malaria drugs: 
Chloroquine, with the recommended dose of 25mg/kg.bw during 3 days and 
Fansidar with the recommended dose of  25/1,25mg/kg.bw.

How much do we really give to patients with a weight of 80-100 kg?
Is it enough with the 1500mg base (10 tablets Chloroquinephosphate, 250mg) to all adults, independent of weight, or shouldn?t we rather give 2000mg to a patient of 80 kg and 2500mg to a patient of 100 kg?
 
I know that many health workers have problems of calculating the right dose. But why do we stop 
at 60 kg in our tables of dose against bodyweight?

If we are under dosing heavier persons, what does this imply for the outcome of the treatment and  
the development of resistance.  

What is the general practise?

I am looking forward to opening up for experiences, opinions and facts on this problem.

Björn von Hofsten
Pharmaceutical Adviser
Programa Nacional de Medicamentos Essenciais
pme@ebonet.net
Luanda, Angola
Fax.+244 2 320703

The same applies to mefloquine.  When the drug was launched we 
tried to work out why the recommendation stopped at a particular 
body weight but hit a blank on the pharmacokinetics.  Perhaps one 
of our list members has looked into this issue and can help ?
Leesette
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