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Skeletal Formula of Artesunate
23 Aug 2017

Artesunate IVs, chemotherapy, and immunotherapy

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.

-Dr A