Table 2 Limitations and desired product profiles of drugs for malaria, leishmania, Human African Trypanosomiasis, and Chagas disease
Drugs | Limitations | Desired profile of new products |
|---|---|---|
Malaria | ||
Quinine (Quinine sulphate , Quinimax) (1930) | Compliance, resistance (1960s), safety | Active against resistant strains; oral formulations, with option for parenteral use for patients in coma; use in pediatric formulation; potential combination with other agents; use in pregnancy; cure in three days; stable under tropical conditions; inexpensive. |
Chloroquine (Nivaquine , Aralen) (1945) | Resistance (1950s) | |
Primaquine (1948) | Safety, contra-indicated in G6PD deficiency, pregnancy | |
Sulphadoxine-pyrimethamine (Maloxine , Fansidar) (1961) | Resistance (1960s) | |
Amodiaquine (Camoquin) (1950) | Resistance, safety | |
Artemisinins (1994) | Cost, resistance (2008), potential neurotoxicity | |
Mefloquine (Lariam , Mephaquine) (1984) | Resistance (1980s), cost, contra-indicated in known or suspected history of neuropsychiatric disorder | |
Resistance, cost, safety, or recent (<3Â weeks) use of Halofantrine | ||
Halofantrine (1975) | Compliance, resistance potential, contra-indicated in cardiac disease and pregnancy | |
Artemether/lumefantrine (Coartem , Mephaquine) (2001) | Compliance, cost, resistance, GMP, potential neurotoxicity | |
Artesunate/amodiaquine (ASAQ) (2007) | Compliance, cost, resistance, GMP, safety, contra-indicated in pregnancy | |
Atovaquone/proguanil (1999) | Cost, resistance potential | |
Tetracycline (1940s), doxycycline (1960s) | Contra-indicated for those aged less than eight years and in pregnancy | |
Clindamycin (Dalacin , Lincocin) (1968) | Efficacy, contra-indicated in severe hepatic or renal impairment; history of gastrointestinal disease, especially colitis | |