Artesunate suppositories work with artemisinin suppositories in severe malaria was conducted in Viet Nam in the early 1990s, and clinical trials of rectal artesunate followed by mefloquine treatment in moderately severe malaria were conducted in the mid-1990s in Thailand. A major placebo-controlled clinical trial published in 2009 found that "if patients with severe malaria cannot be treated orally and access to injections will take several hours, a single inexpensive artesunate [rectal] suppository at the time of referral substantially reduces the risk of death or permanent disability." Artesunate suppositories Artesunate suppositories are used for the treatment of malaria. Artesunate is an antimalarial water-soluble
Mefloquine clearance is through the liver, and the primary means of excretion is through the bile and feces, as opposed to only 4% to 9% excreted through the urine. During long-term use, the plasma half-life remains unchanged. Liver function tests should be performed during long-term administration of mefloquine. Alcohol use should be avoided during treatment with mefloquine. Mefloquine is a chiral molecule with two asymmetric carbon centres, which means it has four different stereoisomers. The drug is currently manufactured and sold as a racemate of the ("R","S")- and ("S","R")-enantiomers by Hoffman-LaRoche, a Swiss pharmaceutical company. Essentially, it is two drugs in