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Table 2 Limitations and desired product profiles of drugs for malaria, leishmania, Human African Trypanosomiasis, and Chagas disease

From: Control of malaria and other vector-borne protozoan diseases in the tropics: enduring challenges despite considerable progress and achievements

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 (<3 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
  1. Adapted from Schiltzer [68], Nwaka and Ridley [75], Nwaka and Hudson [78] and DNDi [79].