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Drug Safety
Published in: Drug Safety 2/2013

01-02-2013 | Practical Application

Malaria Prophylaxis in Patients with Renal Impairment

A Review

Authors: Sabine Amet, Sarah Zimner-Rapuch, Vincent Launay-Vacher, Nicolas Janus, Gilbert Deray

Published in: Drug Safety | Issue 2/2013

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Abstract

Malaria is an endemic and potentially lethal disease transmitted by the protozoan parasite Plasmodium. It is currently endemic in more than 100 countries, which are visited by 125 million international travellers every year. For dialysis and renal insufficiency patients it becomes increasingly easier to travel to these countries thanks to the recent advances in renal replacement therapy. However, the pharmacokinetics of some prophylactic agents in malaria are altered, which may modify the effectiveness and safety of such treatments and the way they should be prescribed. Clinicians should be aware of these alterations which require subsequent dosage adjustments. This review provides recommendations on the use of antimalarial drugs, alone or in combination, in patients with renal impairment. These recommendations depend on the prevalence of Plasmodium falciparum chloroquine resistance, as defined by the WHO. Furthermore, fixed-dose combinations cannot be used in patients with creatinine clearance below 60 mL/min since the tablets available do not allow appropriate dosage adjustment for each drug. Chloroquine and proguanil require dosage adjustments, while atovaquone, doxycycline and mefloquine do not.
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Metadata
Title
Malaria Prophylaxis in Patients with Renal Impairment
A Review
Authors
Sabine Amet
Sarah Zimner-Rapuch
Vincent Launay-Vacher
Nicolas Janus
Gilbert Deray
Publication date
01-02-2013
Publisher
Springer International Publishing AG
Published in
Drug Safety / Issue 2/2013
Print ISSN: 0114-5916
Electronic ISSN: 1179-1942
DOI
https://doi.org/10.1007/s40264-013-0017-y

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