Peringatan Keamanan

Studies of piperaquine in monkeys and dogs have shown some hepatotoxicity and reversible depression in white blood cells and neutrophils FDA Label. Additional observations include infiltration of macrophages with intracytoplasmic basophilic granular material consistent with phospholipidosis and degenerative lesions in numerous organs and tissues. These effects were seen at exposure levels similar to clinical dosing in humans. At high doses, piperaquine can interfere with cardiac conduction and produce effects on blood pressure. Mild phototoxicity has been observed with piperaquine in rats exposed to UV light.

Piperaquine

DB13941

small molecule approved experimental investigational

Deskripsi

Piperaquine is an antimalarial agent first synthesized in the 1960's and used throughout China A31550. Its use declined in the 1980's as piperaquine resistant strains of *Plasmodium falciparum* appeared and artemisinin derivatives became available. It has come back into use in combination with the artemisinin derivative DB11638 as part of the combination product Eurartesim FDA Label. Eurartesim was first authorized for market by the European Medicines Agency in October 2011.

Struktur Molekul 2D

Berat 535.52
Wujud solid

Peta Jejaring Molekuler
Legenda: Obat • Target • Gen • Enzim • (Panah → menunjukkan arah efek / relasi) • Transporter • Carrier

Profil Farmakokinetik

Waktu Paruh (Half-Life) The terminal elimination half-life was observed to be 576h or 24 days [L1149]. This is thought to be due to the extensive distribution of piperaquine.
Volume Distribusi Piperaquine is thought to distribute into a central compartment with an apparent volume of 26.7 L/kg, and two peripheral compartments with apparent volumes of 76.8 L/kg and 617 L/kg [L1149]. These combine for a total volume of distribution of 720.5 L/kg.
Klirens (Clearance) The mean apparent total clearance has been observed to be 1.12 L/h/kg in adult malaria patients [L1149].

Absorpsi

Piperaquine is slowly absorbed and exhibits multiple peaks in its plasma concentration curve suggestive of enterohepatic recycling occurring alongside the absorption process L1149. Due to this complication there is no discreet value for bioavailability but piperaquine is highly absorbed into systemic circulation. When taken with food, Cmax increases by 217% and mean exposure increases by 177%. Tmax is not affected by food and remains around 5 h FDA Label. Piperaquine has been observed to accumulate more in females to a degree of 30-50% more than males FDA Label. It also collects in red blood cells similar to DB11638.

Metabolisme

Piperaquine undergoes N-dealkylation, separating its aliphatic bridge from one of the nitrogen-containing rings A31891. The resulting aldehyde is then oxidized to a carboxylic acid to form metabolite 1 (M1). The same nitrogen-containing rings can also undergo hydroxylation at one of two sites to form M3 or M4. M2 is formed via N-oxidation of one of the nitrogens in the quinoline groups at either side of the molecule. M5 results when both of these nitrogens are oxidized. M1 and M2 are the major metabolism products FDA Label. Each of these metabolites were observed in the urine.

Rute Eliminasi

Piperaquine is mainly excreted in the feces with a negligible amount in the urine FDA Label.

Interaksi Obat

608 Data
Lomitapide The metabolism of Lomitapide can be decreased when combined with Piperaquine.
Cilostazol The serum concentration of Cilostazol can be increased when it is combined with Piperaquine.
Eliglustat The metabolism of Eliglustat can be decreased when combined with Piperaquine.
Ibrutinib The metabolism of Ibrutinib can be decreased when combined with Piperaquine.
Artemether The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Artemether.
Lumefantrine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Lumefantrine.
Colchicine The metabolism of Colchicine can be decreased when combined with Piperaquine.
Iloperidone The metabolism of Iloperidone can be decreased when combined with Piperaquine.
Retapamulin The metabolism of Retapamulin can be decreased when combined with Piperaquine.
Tofacitinib The metabolism of Tofacitinib can be decreased when combined with Piperaquine.
Vardenafil The metabolism of Vardenafil can be decreased when combined with Piperaquine.
Eszopiclone The metabolism of Eszopiclone can be decreased when combined with Piperaquine.
Zopiclone The metabolism of Zopiclone can be decreased when combined with Piperaquine.
Lovastatin The metabolism of Lovastatin can be decreased when combined with Piperaquine.
Alfuzosin The metabolism of Alfuzosin can be decreased when combined with Piperaquine.
Alprazolam The metabolism of Alprazolam can be decreased when combined with Piperaquine.
Warfarin The serum concentration of Warfarin can be increased when it is combined with Piperaquine.
Acenocoumarol The serum concentration of Acenocoumarol can be increased when it is combined with Piperaquine.
(R)-warfarin The serum concentration of (R)-warfarin can be increased when it is combined with Piperaquine.
R,S-Warfarin alcohol The serum concentration of R,S-Warfarin alcohol can be increased when it is combined with Piperaquine.
S,R-Warfarin alcohol The serum concentration of S,R-Warfarin alcohol can be increased when it is combined with Piperaquine.
(S)-Warfarin The serum concentration of (S)-Warfarin can be increased when it is combined with Piperaquine.
Midazolam The serum concentration of Midazolam can be increased when it is combined with Piperaquine.
Tacrolimus The serum concentration of Tacrolimus can be increased when it is combined with Piperaquine.
Atorvastatin The metabolism of Atorvastatin can be decreased when combined with Piperaquine.
Thiethylperazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Thiethylperazine.
Promazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Promazine.
Prochlorperazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Prochlorperazine.
Chlorpromazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Chlorpromazine.
Triflupromazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Triflupromazine.
Fluphenazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Fluphenazine.
Thioridazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Thioridazine.
Moricizine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Moricizine.
Trifluoperazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Trifluoperazine.
Perphenazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Perphenazine.
Mesoridazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Mesoridazine.
Acetophenazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Acetophenazine.
Promethazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Promethazine.
Alimemazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Alimemazine.
Methotrimeprazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Methotrimeprazine.
Periciazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Periciazine.
Acepromazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Acepromazine.
Aceprometazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Aceprometazine.
Pipotiazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Pipotiazine.
Thioproperazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Thioproperazine.
BL-1020 The risk or severity of QTc prolongation can be increased when Piperaquine is combined with BL-1020.
Cyamemazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Cyamemazine.
Methylene blue The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Methylene blue.
Propiopromazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Propiopromazine.
Perazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Perazine.
Butaperazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Butaperazine.
Chlorproethazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Chlorproethazine.
Thiazinam The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Thiazinam.
Dixyrazine The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Dixyrazine.
Perphenazine enanthate The risk or severity of QTc prolongation can be increased when Piperaquine is combined with Perphenazine enanthate.
Dapsone The risk or severity of adverse effects can be increased when Piperaquine is combined with Dapsone.
Fluvoxamine The metabolism of Piperaquine can be decreased when combined with Fluvoxamine.
Troglitazone The metabolism of Piperaquine can be decreased when combined with Troglitazone.
Fluoxetine The metabolism of Piperaquine can be decreased when combined with Fluoxetine.
Nabilone The metabolism of Piperaquine can be decreased when combined with Nabilone.
Mifepristone The metabolism of Piperaquine can be decreased when combined with Mifepristone.
Felbamate The metabolism of Piperaquine can be decreased when combined with Felbamate.
Sulfinpyrazone The metabolism of Piperaquine can be decreased when combined with Sulfinpyrazone.
Iproniazid The metabolism of Piperaquine can be decreased when combined with Iproniazid.
Medical Cannabis The metabolism of Piperaquine can be decreased when combined with Medical Cannabis.
Imatinib The metabolism of Piperaquine can be decreased when combined with Imatinib.
Valproic acid The metabolism of Piperaquine can be decreased when combined with Valproic acid.
Fluconazole The metabolism of Piperaquine can be decreased when combined with Fluconazole.
Floxuridine The metabolism of Piperaquine can be decreased when combined with Floxuridine.
Nicardipine The metabolism of Piperaquine can be decreased when combined with Nicardipine.
Miconazole The metabolism of Piperaquine can be decreased when combined with Miconazole.
Gemfibrozil The metabolism of Piperaquine can be decreased when combined with Gemfibrozil.
Sulfaphenazole The metabolism of Piperaquine can be decreased when combined with Sulfaphenazole.
Vemurafenib The risk or severity of QTc prolongation can be increased when Vemurafenib is combined with Piperaquine.
Pitolisant The serum concentration of Piperaquine can be decreased when it is combined with Pitolisant.
Bupropion The serum concentration of Bupropion can be increased when it is combined with Piperaquine.
Aripiprazole The metabolism of Aripiprazole can be decreased when combined with Piperaquine.
Aripiprazole lauroxil The metabolism of Aripiprazole lauroxil can be decreased when combined with Piperaquine.
Metreleptin The metabolism of Piperaquine can be increased when combined with Metreleptin.
Azithromycin The metabolism of Azithromycin can be decreased when combined with Piperaquine.
Cephalexin The metabolism of Cephalexin can be decreased when combined with Piperaquine.
Norethisterone The metabolism of Norethisterone can be decreased when combined with Piperaquine.
Rosuvastatin The metabolism of Rosuvastatin can be decreased when combined with Piperaquine.
Allylestrenol The metabolism of Allylestrenol can be decreased when combined with Piperaquine.
Zuclopenthixol The metabolism of Zuclopenthixol can be decreased when combined with Piperaquine.
Roflumilast The serum concentration of Roflumilast can be increased when it is combined with Piperaquine.
Vorapaxar The metabolism of Vorapaxar can be decreased when combined with Piperaquine.
Suvorexant The metabolism of Suvorexant can be decreased when combined with Piperaquine.
Tasimelteon The metabolism of Tasimelteon can be decreased when combined with Piperaquine.
Nintedanib The metabolism of Nintedanib can be decreased when combined with Piperaquine.
Tenofovir alafenamide The metabolism of Tenofovir alafenamide can be decreased when combined with Piperaquine.
Dihydroergocornine The metabolism of Dihydroergocornine can be decreased when combined with Piperaquine.
Duvelisib The metabolism of Duvelisib can be decreased when combined with Piperaquine.
Gilteritinib The metabolism of Gilteritinib can be decreased when combined with Piperaquine.
9-aminocamptothecin The metabolism of 9-aminocamptothecin can be decreased when combined with Piperaquine.
Methylprednisone The metabolism of Methylprednisone can be decreased when combined with Piperaquine.
Dihydroergocristine The metabolism of Dihydroergocristine can be decreased when combined with Piperaquine.
Dihydroergocryptine The metabolism of Dihydroergocryptine can be decreased when combined with Piperaquine.
Drospirenone The metabolism of Drospirenone can be decreased when combined with Piperaquine.
Elexacaftor The metabolism of Elexacaftor can be decreased when combined with Piperaquine.

Referensi & Sumber

Artikel (PubMed)
  • PMID: 15610051
    Davis TM, Hung TY, Sim IK, Karunajeewa HA, Ilett KF: Piperaquine: a resurgent antimalarial drug. Drugs. 2005;65(1):75-87.
  • PMID: 28072872
    Hoglund RM, Workman L, Edstein MD, Thanh NX, Quang NN, Zongo I, Ouedraogo JB, Borrmann S, Mwai L, Nsanzabana C, Price RN, Dahal P, Sambol NC, Parikh S, Nosten F, Ashley EA, Phyo AP, Lwin KM, McGready R, Day NP, Guerin PJ, White NJ, Barnes KI, Tarning J: Population Pharmacokinetic Properties of Piperaquine in Falciparum Malaria: An Individual Participant Data Meta-Analysis. PLoS Med. 2017 Jan 10;14(1):e1002212. doi: 10.1371/journal.pmed.1002212. eCollection 2017 Jan.
  • PMID: 16956956
    Tarning J, Bergqvist Y, Day NP, Bergquist J, Arvidsson B, White NJ, Ashton M, Lindegardh N: Characterization of human urinary metabolites of the antimalarial piperaquine. Drug Metab Dispos. 2006 Dec;34(12):2011-9. doi: 10.1124/dmd.106.011494. Epub 2006 Sep 6.

Contoh Produk & Brand

Produk: 5 • International brands: 0
Produk
  • Eurartesim
    Tablet, film coated • - • Oral • EU • Approved
  • Eurartesim
    Tablet, film coated • - • Oral • EU • Approved
  • Eurartesim
    Tablet, film coated • - • Oral • EU • Approved
  • Eurartesim
    Tablet, film coated • - • Oral • EU • Approved
  • Eurartesim
    Tablet, film coated • - • Oral • EU • Approved

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