Botanical Extracts and IV Drip Therapy
Artesunate Monograph for Parenteral Use
Artemisia-based medications are used globally for their anti-malarial properties. The pharmacology and safety of these agents have been well-studied and published in scientific literature. While research into their use against cancer cell lines is newer, it is promising and also supported by scientific studies. Based on clinical experience with over one thousand parenteral doses of artesunate administered to patients with advanced cancers, we find this agent to be safe and potentially valuable in oncology. Although more specific clinical data is required, artesunate’s basic pharmacology suggests that further investigation in cancer treatment is warranted.
Safety:
Artesunate, derived from Artemisia, is commonly administered via the intravenous (IV) or intramuscular (IM) route, with other routes like rectal and oral also available. It has shown a highly tolerable and low side effect profile in both adult and pediatric populations when used at standard parenteral doses. Some toxicities have been reported with certain Artemisinin derivatives in animal studies, but these are typically not observed in humans when artesunate is used. Oil-based parenterals, which are not recommended for human use, have caused adverse effects, but these are not seen with artesunate.
In pediatric studies, including the large AQUAMAT trial involving 2,712 children, artesunate demonstrated a similar safety profile to adults, leading to its recommendation by the WHO for use in children infected with malaria.
Pharmacology and Mechanism of Action:
Multiple cell line studies demonstrate the anti-tumor properties of Artemisinin agents. Research has shown that artesunate exhibits antiangiogenic activity, inhibits VEGF, and generates reactive oxygen species (ROS) through iron transport mechanisms, leading to apoptosis in cancer cells. A xenograft model of pancreatic cancer demonstrated artesunate’s effectiveness in tumor regression, comparable to gemcitabine. Other studies show that artesunate has therapeutic effects in certain chronic infections and autoimmune conditions, with potential implications for immunoregulation in cancer therapy.
IV Drip Integration with Artesunate:
IV Drip therapy offers a controlled and efficient method for administering artesunate, particularly in oncology settings where its potential anti-tumor effects are being investigated. IV administration ensures precise dosing and immediate therapeutic effects, making it a valuable tool for practitioners dealing with cancer patients or chronic infections. Combining artesunate with high-dose intravenous vitamin C in an IV Drip has been shown to enhance ROS activity and potentially increase therapeutic outcomes. For best results, IV vitamin C should follow the administration of artesunate.
IV Compatibility:
It is important to note that artesunate should not be mixed with other additives in the IV bag. High-dose vitamin C is best administered following the artesunate infusion to sustain ROS activity, which plays a key role in its therapeutic mechanism.
Screening and Lab Studies:
Patients should be screened for intolerance to Artemisia compounds, and baseline lab studies such as CBC, chemistry panel, and G6PD should be conducted before beginning therapy. During therapy, particularly in frequent or high-dose regimens, regular monitoring of CBC and iron studies is advised to detect potential anemia or iron depletion, as artesunate may deplete iron or copper due to its mechanism of action involving transition metals.
Other Lab Studies and Imaging:
Additional lab and imaging studies should be performed as clinically indicated for each patient. Patients with latent infections may experience a rise in temperature or cytokine-related effects following artesunate administration.