α-β Arteether Injection – Onco India International

Overview
α-β Arteether Injection, manufactured by Onco India International, is a potent antimalarial medication from the artemisinin class. Derived from Artemisia annua (sweet wormwood), it is a semi-synthetic derivative of artemisinin. The formulation contains two stereoisomers—α and β arteether—in a fixed ratio, supplied as an oil-based intramuscular injection.

It is highly effective against the schizont stage of Plasmodium falciparum—the deadliest malaria parasite—especially in regions where resistance to standard antimalarials like chloroquine and quinine is widespread.

Uses of α-β Arteether Injection

• Treatment of severe and acute falciparum malaria when first-line medicines such as artesunate are not available.

• Suitable for patients unable to take oral therapy due to vomiting, unconsciousness, or critical illness.

• Particularly useful in resource-limited or remote healthcare settings because it is stable, easy to administer, and convenient to store.

Indications

• Severe or complicated malaria caused by Plasmodium falciparum (resistant strains included)

• Cerebral malaria (neurological symptoms)

• Hyperparasitemia

• Severe anemia

• Acute kidney injury or hepatic dysfunction due to malaria

• Respiratory distress syndrome

Dosage Guidelines

• Adults & Children (above 5 years): 150 mg (3 ml) intramuscularly once daily for 3 consecutive days.

• Children below 5 years: Dose adjusted according to body weight (consult a pediatrician).

• Renal impairment: No adjustment needed.

• Hepatic dysfunction: Caution is advised.

Directions for Use

• Injection should be administered only by a trained healthcare professional.

• Given deeply intramuscularly in the gluteal muscle (alternate sides each day).

• Use sterile syringe and needle; administer immediately after opening the ampoule.

• Discard if the solution is discoloured or contains particles.

Contraindications

Avoid or use with caution in:

• Allergy to artemisinin or derivatives

• Pregnancy (first trimester – risk of fetal neurodevelopmental issues)

• Pre-existing neurological disorders

• Severe hepatic dysfunction

• Not recommended for malaria prevention (chemoprophylaxis)

Benefits

• Highly effective against drug-resistant P. falciparum strains

• Rapid action with parasite clearance usually within hours

• Convenient once-daily dosing for just three days

• Useful where IV therapy is not feasible

• Reduces hospitalization time in many patients

Mechanism of Action

Once administered, α-β Arteether is converted into dihydroartemisinin, the active metabolite.

• It reacts with iron inside the parasite’s digestive vacuole, generating free radicals and reactive oxygen species (ROS).

• These damage parasite proteins, membranes, and organelles, leading to rapid death of the parasite.

• Its lipophilic oil-based formulation allows slow and sustained release, ensuring adequate blood levels with once-daily dosing.

Drug Interactions

May be used along with:

• IV fluids (hydration)

• Antipyretics (paracetamol)

• Antiemetics (ondansetron)

• Anticonvulsants (if seizures occur)

Avoid or use cautiously with:

• Other artemisinin derivatives (↑ toxicity risk)

• QT-prolonging drugs (e.g., macrolides, fluoroquinolones, haloperidol)

• CYP450 inducers/inhibitors (e.g., rifampicin, phenytoin)

• Neurotoxic drugs (e.g., isoniazid)

Concerns & Side Effects

• Possible neurotoxicity (seen in animal studies, not proven in humans at therapeutic doses)

• Recurrence of malaria if follow-up ACT (Artemisinin Combination Therapy) is not given

• Pain, swelling, or abscess at injection site (rare)

• Limited safety data in pregnancy and pediatrics

Precautions & Warnings

• Should not be used as first-line therapy if artesunate is available.

• Monitor liver and kidney function tests.

• Watch for neurotoxic effects (confusion, seizures), allergic reactions, or arrhythmias.

• Extra caution in pregnant women, breastfeeding mothers, elderly patients, and those with heart rhythm issues.

Supportive Care & Lifestyle Tips

• Complete the full treatment along with follow-up ACT.

• Prevent reinfection with mosquito nets, repellents, and protective clothing.

• Stay hydrated and eat nutrient-rich, easily digestible foods (soups, cereals, boiled vegetables).

• Avoid smoking and alcohol (liver metabolism).

• Rest adequately until recovery.

Comparison with Other Antimalarials

Quinine

• Longstanding use but requires IV infusion every 8 hours.

• Side effects: hypoglycemia, tinnitus, arrhythmias.

• Less practical in remote settings.

Artesunate

• WHO-recommended first-line treatment for severe malaria.

• Faster parasite clearance and superior safety.

• Requires multiple IV/IM doses over 24 hours.

• Generally considered more effective than arteether.

Storage Instructions

• Store at 20–25°C, away from light, moisture, and freezing.

• Keep ampoules in original packaging until use.

• Keep out of reach of children and pets.

α-β Arteether Injection by Onco India International offers a reliable, effective treatment for severe Plasmodium falciparum malaria, especially in regions with limited access to IV therapy or artesunate.