P-Alaxin DS tabl. #6

1. What is P-Alaxin DS/TS indicated for?

Uncomplicated malaria in adults, children, and infants.

2. How should P-Alaxin DS/TS be administered?

Orally with water on an empty stomach, at least three hours after the last food intake and no food for three hours after each dose. Tablets can be crushed and mixed with water for patients who cannot swallow them.

3. What are the different strengths of P-Alaxin available, and how is the dosage determined?

Dosage is determined by body weight and administered once daily for three days:
* 25 kg to < 36 kg: One P-Alaxin tablet (40 mg/320 mg)
* 36 kg to < 60 kg: One and a half P-Alaxin DS tablets (60 mg/480 mg)
* 60 kg to < 80 kg: Two P-Alaxin DS tablets (80 mg/640 mg)
* 80 kg and above: Two and a half P-Alaxin TS tablets (100 mg/800 mg)

4. What should be done if a dose of P-Alaxin DS/TS is missed or vomited?

Missed dose: Take as soon as possible and continue the regimen.
Vomiting within 30 minutes: Re-administer the whole dose.
Vomiting between 30-60 minutes: Re-administer half the dose.
Only re-dose once. If vomiting persists, use an alternative antimalarial.

5. What are the contraindications for using P-Alaxin DS/TS?

Hypersensitivity to ingredients, severe malaria, congenital or acquired long QT syndrome, family history of sudden death or congenital long QT, history of cardiac arrhythmias or bradycardia, predisposing cardiac conditions for arrhythmia, electrolyte disturbances, concomitant use of QTc-prolonging medications.

6. What are the special warnings and precautions for P-Alaxin DS/TS?

Not for complicated malaria; consider piperaquine's long half-life when starting other antimalarials; caution with CYP3A4-interacting drugs; avoid in patients with long QT conditions/medications; monitor for delayed hemolytic anemia; pediatric patients are susceptible to electrolyte disturbances; caution in patients with hepatic/renal impairment; avoid in pregnancy, especially first trimester; do not breastfeed while taking.

7. What are the pharmacodynamic effects of dihydroartemisinin and piperaquine?

Dihydroartemisinin: Causes free-radical damage to parasite membranes.
Piperaquine: May inhibit haem-digestion, interfere with chloroquine efflux transporters, disrupt mitochondrial function, and affect parasite transport proteins.

8. What are the pharmacokinetics of dihydroartemisinin and piperaquine?

Dihydroartemisinin: Rapidly absorbed, maximum concentration within one hour, half-life ~4 hours, metabolized into inactive metabolites.
Piperaquine: 80-90% absorbed within 24 hours, widely distributed, long half-life (~9.4 days), excreted in bile.

9. What are the reported adverse effects of P-Alaxin DS/TS?

See original text for a comprehensive list. Common effects include anemia, headache, QTc prolongation, vomiting, diarrhea, nausea, abdominal pain, and cough.

10. What should be done in case of an overdose of P-Alaxin DS/TS?

Symptomatic and supportive therapy, ECG monitoring.