Comparative Pharmacology
Head-to-head clinical analysis: FANSIDAR versus QUININE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: FANSIDAR versus QUININE.
FANSIDAR vs Quinine
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Fansidar combines sulfadoxine, a sulfonamide dihydrofolate reductase inhibitor, and pyrimethamine, a dihydrofolate reductase inhibitor, synergistically inhibiting folate synthesis in Plasmodium species, leading to nucleic acid synthesis inhibition and parasite death.
Quinine is a cinchona alkaloid that acts as a blood schizonticide against Plasmodium falciparum. It inhibits heme polymerase, leading to accumulation of toxic heme, and disrupts parasite membrane integrity. It also has mild analgesic and antipyretic properties.
For acute uncomplicated malaria: 3 tablets (25 mg pyrimethamine + 500 mg sulfadoxine per tablet) orally as a single dose on Day 0 and Day 1 (total 6 tablets); alternatively, 3 tablets as a single dose. For severe malaria: 3 tablets orally as a single dose, repeated at weekly intervals if necessary.
Adults: 648 mg (2 capsules) orally every 8 hours for 7 days for uncomplicated chloroquine-resistant malaria, typically used in combination with other antimalarials.
None Documented
None Documented
Clinical Note
moderateQuinine + Gatifloxacin
"Quinine may increase the hypoglycemic activities of Gatifloxacin."
Clinical Note
moderateQuinine + Rosoxacin
"Quinine may increase the hypoglycemic activities of Rosoxacin."
Clinical Note
moderateQuinine + Levofloxacin
"Quinine may increase the hypoglycemic activities of Levofloxacin."
Clinical Note
moderateQuinine + Trovafloxacin
"Quinine may increase the hypoglycemic activities of Trovafloxacin."
Sulfadoxine: 100-200 hours; pyrimethamine: 80-100 hours; clinical context: unusual for antimalarials, allows single-dose therapy for uncomplicated P. falciparum
Terminal elimination half-life: 18 hours (range 8–21 h) in healthy adults; prolonged to 26–44 h in severe malaria or hepatic impairment.
Renal: sulfadoxine 80% (unchanged), pyrimethamine 20-40% (unchanged); fecal: sulfadoxine <5%, pyrimethamine <5%
Renal: ~20% unchanged; Hepatic metabolism (CYP3A4) to inactive metabolites, excreted in urine and feces. Total renal elimination of parent and metabolites ~80%.
Category C
Category C
Antimalarial
Antimalarial