INDICES> Artemisinin Derivatives in General (2)

[DID <did.jms@imul.com>]

E-DRUG: Artemisinin Derivatives in General (2)
-----------------------------------------------------------

Dear Mahmood,

You are right.  We have the same problem with artemisinin derivatives
in
Uganda.

I will just add to the artesunate.

The loading dose for generic artemether in Uganda, according to the
product insert is: 200mg followed by 100mg daily for 4 days.
Patients and prescribers faithfully follow that dosing.

But the loading dose of the branded artemether
(Artenam), according to the product insert is: 300mg followed by 100mg
daily for 4 days.

Again patients and prescribers religiously follow that.

However, we have received reports that generic artemether is not as
effective as Artenam. Some patients and a number of
prescribers now prefer Artenam to the generic, for
reasons which have to do with clinical outcome.  That is not enough.

Subdosing and underdosing medicines is one of the major and
practically
avoidable causes of resistance.  And development of resistance to
medicines should be of public health concern.

The number of years, for which artemether will be valuable as an
antimalarial can be greatly reduced.

One reason for that reduction is having one product adequately dosed
and
the other improperly dosed.

Drug Regulatory Agencies usually allow such contradictory products on
the
market along one another.

May The World Health Organisation (WHO) and other independent drug
efficacy reviewers assist.

Otherwise, the life-span of artemisinin derivatives is likely to be
reduced by clearly preventable  oversights.

Sincerely,

George Kibumba, MPS(Uganda).

Drug Information Pharmacist
Drug Information Desk,
Joint Medical Store,
P.O.BOX 4501, KAMPALA, Uganda(E.A)
e-mail: did.jms@imul.com
Tel:    256-41-268482
fax:    256-41-267298


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