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Side Effects of
Antimalarials

FIND A PHARMACIST WHO OFFERS GENETIC TESTING FOR Antimalarials

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Description: Antimalarials are used in the treatment of Malaria – a mosquito borne protozoan infection that causes fever, fatigue, vomiting and in some cases death.
Antimalarial medications can be given prophylactically or after and infection is present.
They are a wide ranging group and include:

  • Chloroquine
  • Amodiaquine
  • Proguanil
  • Sulfonamides
  • Atovaquone
  • Artemisinin
  • Doxycycline
  • Clindamycin
  • (Physicians’ Desk Reference, 70th Ed., 2016)

    Common Side Effects of Atovaquone

    Side effects of atovaquone include:

  • Rash
  • Diarrhea
  • Nausea
  • Bronchospasm
  • Abdominal pain
  • Constipation
  • Elevated ALT/AST (evidence of liver damage)
  • Anemia (low red blood cells)
  • Neutropenia (low white blood cells)
  • Hyponatremia (low blood concentration of sodium)
  • Hyperglycemia (high blood concentration of glucose)
  • Fever
  • Infections
  • Pain
  • Dyspnea (difficulty breathing)
  • Sinusitis
  • Headache
  • Anxiety
  • Depression
  • Dizziness
  • Hypotension (low blood pressure)
  • (Mepron Drug Label as reported by the U.S. Food and Drug Administration;

    Expert Opinions on Drug Safety “Adverse neuropsychiatric effects of antimalarial drugs, Apr 2016).

    Common Side Effects of Proguanil

    Side effects of proguanil, according to the Malarone (proguanil) label, August 2004), include:

  • Pruritus
  • Nausea
  • Vomiting
  • Diarrhea
  • Mouth ulcers
  • Anorexia
  • Dyspepsia (indigestion)
  • Myalgia
  • Back pain
  • Common Side Effects of Mefloquine

    Mefloquine is used as a prophylaxis and to treat active Malaria infections. Side effects include:

  • Vomiting
  • Dizziness
  • Syncope
  • Extrasystoles
  • (Mefloquine Hydrochloride label as reported by the FDA, June 2013).

    Individual Differences in the Metabolism of Antimalarial Medications

    Many antimalarial medications are associated with side effects. Some patients may develop multiple severe adverse reactions that may cause cessation of the drug. This variability between patients is accounted for by pharmacogenetics – the science of how one’s genes affect their reaction to pharmacological agents. In other words, genetic differences among individuals have been shown to increase or decrease the probability of developing side effects when taking antimalarials.

    Individual differences in the genes that encode for the enzymes responsible for metabolizing antimalarial medications affect patient’s’ unique response and therefore dosing. The exact individual variations (called “polymorphisms”) in the enzymes or chemical receptors that interact with antimalarials will vary between drugs.
    Identifying these polymorphisms can significantly aid clinical decision-making. Unfortunately, routine genomic screening is not carried out by most healthcare providers. Normally prescribers rely on trial and error to find the optimal dose of a medication for a patient – a process which can take an time and result in needless suffering and serious potential side effects, as in the case of antimalarials.

    Understand Your Risks with the Rxight® Genetic Test

    With Rxight® pharmacogenetic testing (which is a type of DNA testing that analysis of a patient’s genotype to evaluate how well they can metabolize medications) clinicians can alter the starting dose or change a drug dependent on an individual’s polymorphisms as outlined in the Rxight® test results, which will be reviewed in detail.
    Specifically, Rxight® is based on the sequencing of a number of genes (including CYP2C19) to establish how a patient is likely to respond to hundreds of clinically relevant prescription and over-the-counter medications, across dozens of pharmacological classes, including antimalarials. With one simple cheek swab by a participating pharmacist, which is analyzed at our lab within days, your prescriber(s) will have details on your risk for developing side effects or medication inefficacy based on your unique genotype, and thus can develop a pharmacotherapy program tailored to you.

    Contributors to this Article:
    Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry

    Antimalarials Tested Include:

    • Proguanil (Paludrine)

    Read more about Rxight® Genetic Testing For Medication Effectiveness