Pyronaridine

Chemical properties

solid

Definition

ChEBI: Pyronaridine is an aminoquinoline.

Antimicrobial activity

Pyronaridine is active against the asexual erythrocytic stage of P. falciparum with little or no activity against gametocytes or the hepatic stage. In-vitro blood schizonticide activities are in the range of 0.001–0.03 mg/L, showing a moderate correlation to chloroquine resistance. However, this correlation varies between studies and does not seem to be clinically significant. It is also active against P. vivax, P. ovale and P. malariae. Antagonistic interactions with artemisinins were reported in vitro, but synergy with artesunate has been observed in rodent models.

Acquired resistance

Decreasing in-vitro sensitivity has been observed in China.

Pharmaceutical Applications

An aza-aminoacridine formulated for oral use. A Mannichbase derivative of mepacrine.

Pharmacokinetics

Peak plasma concentrations are reached after 3–14 h depending upon the formulation; there is also considerable interindividual variation. Elimination half-lives of 63–190 h have been reported, again dependent upon the formulation.

Clinical Use

Treatment of uncomplicated P. falciparum and P. vivax malaria
A fixed-dose combination with artesunate (Pyramax) is being developed for uncomplicated P. falciparum and P. vivax malaria.

Side Effects

It is well tolerated and no outstanding toxic effects have been reported.