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Skeletal Formula of Artesunate

Hi Dr. A!

There is another doctor who has concerns who has concerns about IV artesunate interfering with CYP2C9 (in this case FOLFOX) and I am wondering if artesunate needs to be avoided with any chemotherapy or immunotherapy drugs that you know of.

From what my brain remembers, I do not remember learning of any interactions to watch out for during any IV seminars I have been to.

She is also wondering about the half life of artesunate.

As always, your time and expertise is so appreciated!!

Dr Anderson:

A quick reply, since experience in actual human cases, beats theoretical concerns every time (in any evidence based format anyway):

  1. Artesunate IV (ART) has a t1/2 between 2.5 and 15 min depending on the source read.
  2. It has synergy with the constituents of FOLFOX (as does ascorbate)
  3. In hundreds of co-administrations (in my research and clinical work in and out of hospital settings) of FOLFOX / FOLFIRI / FOLFIRINOX and HDIVC/ART we have seen only synergy and improved patient outcomes.
  4. There are no practical, pharmacologic or realistic concerns with concurrent use.

Thanks
-Dr A

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