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Combination of
Trade namesPyramax[1]
Other namesArtesunate/pyronaridine tetraphosphate[1]
Clinical data
Routes of
By mouth[2]
Defined daily dosenot established[3]

Artesunate/pyronaridine, sold under the brand name Pyramax, is a fixed-dose combination medication for the treatment of malaria.[4][1] It can be used for malaria of both the P. falciparum and P. vivax types.[1] It combines artesunate and pyronaridine.[4] It is taken by mouth.[2]

The combination is generally well tolerated.[1] Side effects may include headache, vomiting, or cough.[1] Use in those with severe liver disease or kidney disease is not recommended.[2] Use is not generally recommended in early pregnancy.[2] However, there are no other options and if treatment may save the mother's life it may be used.[2] The two components work by different mechanisms.[2]

It is on the World Health Organization's List of Essential Medicines.[4] In 2010 the wholesale cost of a course of treatment in the developing world was between 0.55 and 2.18 USD.[1]

Medical uses

Artesunate/pyronaridine is used for malaria of both the P. falciparum and P. vivax types.[1] It is not recommended for severe disease.[2]

A 2019 review found that the combination compared well to artemether/lumefantrine.[5] Benefits also appear similar to mefloquine together with artesunate.[5] It is not recommended for the prevention of malaria.[2]


The defined daily dose is not established[3]


  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 "Application for inclusion in the WHO Model List of essential medicines" (PDF). WHO. Nov 2010. Archived (PDF) from the original on 8 December 2019. Retrieved 29 June 2017. Cite error: Invalid <ref> tag; name "WHO2010" defined multiple times with different content
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 "Pyramax 180 mg/60 mg Film-coated tablet" (PDF). EMA. Archived from the original (PDF) on 14 December 2017. Retrieved 13 December 2017.
  3. 3.0 3.1 "WHOCC - ATC/DDD Index". Archived from the original on 1 July 2021. Retrieved 11 September 2020.
  4. 4.0 4.1 4.2 World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  5. 5.0 5.1 Pryce J, Hine P (January 2019). "Pyronaridine-artesunate for treating uncomplicated Plasmodium falciparum malaria". The Cochrane Database of Systematic Reviews. 1: CD006404. doi:10.1002/14651858.CD006404.pub3. PMC 6353203. PMID 30620055.

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