U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C16H26O5
Molecular Weight 298.3746
Optical Activity UNSPECIFIED
Defined Stereocenters 8 / 8
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of ARTEMETHER

SMILES

[H][C@@]12CC[C@@H](C)[C@]3([H])CC[C@]4(C)OO[C@@]13[C@]([H])(O[C@H](OC)[C@@H]2C)O4

InChI

InChIKey=SXYIRMFQILZOAM-HVNFFKDJSA-N
InChI=1S/C16H26O5/c1-9-5-6-12-10(2)13(17-4)18-14-16(12)11(9)7-8-15(3,19-14)20-21-16/h9-14H,5-8H2,1-4H3/t9-,10-,11+,12+,13+,14-,15-,16-/m1/s1

HIDE SMILES / InChI

Description
Curator's Comment: description was created based on several sources, including: http://www.drugbank.ca/drugs/DB06697 http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7866ec19-dfac-47d4-a53f-511a12643cbf

Artemether is an antimalarial agent used to treat acute uncomplicated malaria. It is administered in combination with lumefantrine for improved efficacy against malaria. Artemether is rapidly metabolized into an active metabolite dihydroartemisinin (DHA). The antimalarial activity of artemether and DHA has been attributed to endoperoxide moiety. Artemethe involves an interaction with ferriprotoporphyrin IX (“heme”), or ferrous ions, in the acidic parasite food vacuole, which results in the generation of cytotoxic radical species. The generally accepted mechanism of action of peroxide antimalarials involves interaction of the peroxide-containing drug with heme, a hemoglobin degradation byproduct, derived from proteolysis of hemoglobin. This interaction is believed to result in the formation of a range of potentially toxic oxygen and carbon-centered radicals. Other mechanisms of action for artemether include their ability to reduce fever by production of signals to hypothalamus thermoregulatory center. Now, recent research has shown the presence of a new, previously unknown cyclooxygenase enzyme COX-3, found in the brain and spinal cord, which is selectively inhibited by artemether, and is distinct from the two already known cyclooxygenase enzymes COX-1 and COX-2. It is now believed that this selective inhibition of the enzyme COX-3 in the brain and spinal cord explains the ability of artemether in relieving pain and reducing fever which is produced by malaria. The most common adverse reactions in adults (>30%) are headache, anorexia, dizziness, asthenia, arthralgia and myalgia.

CNS Activity

Curator's Comment: Meningeal inflammation increases artemether concentrations in cerebrospinal fluid in сhildrens treated with intramuscular artemether. http://aac.asm.org/content/55/11/5027.full

Originator

Sources: https://www.ncbi.nlm.nih.gov/pubmed/21989013Kexue Tongbao (Chinese Edition) (1979), 24, (14), 667-9.
Curator's Comment: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778258/

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
Eurartesim

Approved Use

Eurartesim is indicated for the treatment of uncomplicated Plasmodium falciparum malaria in adults, adolescents, children and infants 6 months and over and weighing 5 kg or more.
Curative
Eurartesim

Approved Use

Eurartesim is indicated for the treatment of uncomplicated Plasmodium falciparum malaria in adults, adolescents, children and infants 6 months and over and weighing 5 kg or more.
Curative
Artemisinin

Approved Use

Treatment of uncomplicated falciparum malaria in areas where there is evidence that chloroquine, pyrimethamine/sulfadoxine, mefloquine and quinine are ineffective. It should always be administered together with mefloquine in full therapeutic dose.

Launch Date

1984
Curative
COARTEM

Approved Use

Coartem (artemether/lumefantrine) Tablets are indicated for treatment of acute, uncomplicated malaria infections due to Plasmodium falciparum in patients of 5 kg bodyweight and above. Coartem Tablets have been shown to be effective in geographical regions where resistance to chloroquine has been reported [see Clinical Studies (14.1)

Launch Date

2009
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
60 ng/mL
80 mg single, oral
dose: 80 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ARTEMETHER plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
146 ng × h/mL
80 mg single, oral
dose: 80 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ARTEMETHER plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
1.6 h
80 mg single, oral
dose: 80 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ARTEMETHER plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
4.6%
80 mg single, oral
dose: 80 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ARTEMETHER plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
80 mg 3 times / day multiple, oral
Recommended
Dose: 80 mg, 3 times / day
Route: oral
Route: multiple
Dose: 80 mg, 3 times / day
Co-administed with::
lumefantrine, p.o(480 mg, b.i.d)
Sources: Page: p.3
unhealthy
Health Status: unhealthy
Condition: Plasmodium falciparum malaria
Sources: Page: p.3
Disc. AE: QT interval prolonged...
AEs leading to
discontinuation/dose reduction:
QT interval prolonged
Sources: Page: p.3
80 mg 3 times / day multiple, oral
Recommended
Dose: 80 mg, 3 times / day
Route: oral
Route: multiple
Dose: 80 mg, 3 times / day
Co-administed with::
lumefantrine, p.o(480 mg, b.i.d)
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Plasmodium falciparum malaria
Sources: Page: p.1
AEs

AEs

AESignificanceDosePopulation
QT interval prolonged Disc. AE
80 mg 3 times / day multiple, oral
Recommended
Dose: 80 mg, 3 times / day
Route: oral
Route: multiple
Dose: 80 mg, 3 times / day
Co-administed with::
lumefantrine, p.o(480 mg, b.i.d)
Sources: Page: p.3
unhealthy
Health Status: unhealthy
Condition: Plasmodium falciparum malaria
Sources: Page: p.3
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG



Drug as perpetrator​Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
major
yes (co-administration study)
Comment: administration of ketoconazole le to an increase in artemether (2.3-fold), dihydroartemisinin (1.5 fold), and lumefantrine (1.6-fold) exposure in healthy subjects;
Page: 14.0
minor
minor
minor
PubMed

PubMed

TitleDatePubMed
Pharmacokinetics of artesunate after single oral administration to rats.
2001
Demonstrating the validity of natural products as anti-infective drugs.
2001
Antiparasitic properties of medicinal plants and other naturally occurring products.
2001
Artemisinin and derivatives: the future for malaria treatment?
2001 Dec
In vivo-in vitro model for the assessment of clinically relevant antimalarial cross-resistance.
2001 Dec
Artemisinin for treatment of uncomplicated falciparum malaria: is there a place for monotherapy?
2001 Dec
Current progress in the development and use of artemether for chemoprophylaxis of major human schistosome parasites.
2001 Dec
New trends in extraction, identification and quantification of artemisinin and its derivatives.
2001 Dec
Why artemisinin and certain synthetic peroxides are potent antimalarials. Implications for the mode of action.
2001 Dec
The genetics of artemisinin content in Artemisia annua L. and the breeding of high yielding cultivars.
2001 Dec
Redox reaction of artemisinin with ferrous and ferric ions in aqueous buffer.
2001 Dec
Authentication of artemether, artesunate and dihydroartemisinin antimalarial tablets using a simple colorimetric method.
2001 Dec
A comparison of oral artesunate and artemether antimalarial bioactivities in acute falciparum malaria.
2001 Dec
The potential of artemether for the control of schistosomiasis.
2001 Dec
C-16 artemisinin derivatives and their antimalarial and cytotoxic activities: syntheses of artemisinin monomers, dimers, trimers, and tetramers by nucleophilic additions to artemisitene.
2001 Dec 20
Drug resistant falciparum malaria: clinical consequences and strategies for prevention.
2001 Jun
Effects of matrine, artemisinin, tetrandrine on cytosolic [Ca2+]i in guinea pig ventricular myocytes.
2001 Jun
Selective toxicity of dihydroartemisinin and holotransferrin toward human breast cancer cells.
2001 Nov 21
'To search and studdy out the secrett of tropical diseases by way of experiment'.
2001 Nov-Dec
[Prevention and treatment of malaria: in vitro evaluation of new compounds].
2001 Sep
Combination therapy for malaria: the way forward?
2002
Effect of antimalarial drugs on plasmodia cell-free protein synthesis.
2002 Apr
Epidemiology of drug-resistant malaria.
2002 Apr
Efficacy of artesunate and praziquantel in Schistosoma haematobium infected schoolchildren.
2002 Apr
Clinical status and implications of antimalarial drug resistance.
2002 Feb
Deoxyartemisinin derivatives from photooxygenation of anhydrodeoxydihydroartemisinin and their cytotoxic evaluation.
2002 Feb
Inhibition of glutathione S-transferases by antimalarial drugs possible implications for circumventing anticancer drug resistance.
2002 Feb 10
Anhydrodihydroartemisinin and its 10-trifluoromethyl analogue: access to novel d-ring-contracted artemisinin trifluoromethyl ketones.
2002 Feb 22
Mechanism-based design of parasite-targeted artemisinin derivatives: synthesis and antimalarial activity of new diamine containing analogues.
2002 Feb 28
Alkylating capacity and reaction products of antimalarial trioxanes after activation by a heme model.
2002 Feb 8
Plasmodium falciparum: in vitro interactions of artemisinin with amodiaquine, pyronaridine, and chloroquine.
2002 Jan
Transmission electron microscopic observations on ultrastructural damage in juvenile Schistosoma mansoni caused by artemether.
2002 Jan
New chemical and biological aspects of artemisinin-derived trioxane dimers.
2002 Jan
Structure-activity relationships of the antimalarial agent artemisinin. 6. The development of predictive in vitro potency models using CoMFA and HQSAR methodologies.
2002 Jan 17
In vitro antiprotozoal effects of artemisinin on Neospora caninum.
2002 Jan 3
Simple and rapid physico-chemical methods to examine action of antimalarial drugs with hemin: its application to Artemisia annua constituents.
2002 Jan 4
Assessment of the neurotoxicity of oral dihydroartemisinin in mice.
2002 Jan-Feb
Development and validation of a high-performance liquid chromatography-mass spectrometry assay for the determination of artemether and its metabolite dihydroartemisinin in human plasma.
2002 Jul 15
Antiulcerogenic activity of some sesquiterpene lactones isolated from Artemisia annua.
2002 Jun
Management of malaria in Thailand.
2002 Mar
Heme-artemisinin adducts are crucial mediators of the ability of artemisinin to inhibit heme polymerization.
2002 Mar
From mechanistic studies on artemisinin derivatives to new modular antimalarial drugs.
2002 Mar
Inhibition of nitric oxide-dependent activation of soluble guanylyl cyclase by the antimalarial drug, artemisinin.
2002 Mar 1
Adverse effects of the antimalaria drug, mefloquine: due to primary liver damage with secondary thyroid involvement?
2002 Mar 25
First synthesis of 10 alpha-(trifluoromethyl)deoxoartemisinin.
2002 Mar 7
Activity of drugs from traditional Chinese medicine toward sensitive and MDR1- or MRP1-overexpressing multidrug-resistant human CCRF-CEM leukemia cells.
2002 Mar-Apr
Recent investigations of artemether, a novel agent for the prevention of schistosomiasis japonica, mansoni and haematobia.
2002 May
How might qinghaosu (artemisinin) and related compounds kill the intraerythrocytic malaria parasite? A chemist's view.
2002 May
Central role of the spleen in malaria parasite clearance.
2002 May 15
Transferrin overcomes drug resistance to artemisinin in human small-cell lung carcinoma cells.
2002 May 28
Patents

Sample Use Guides

Adults and children: 25 mg/kg on the first day followed by 12.5 mg/kg on the second and third days in combination with mefloquine (15 mg/kg) in a single dose on the second day. In some areas, a higher dose (25 mg/kg) of mefloquine may be required for a cure to be obtained.
Route of Administration: Oral
In Vitro Use Guide
Artemisinine was active against 3 chloroquine-resistant strains of Plasmodium falciparum, strains K1 and T996 from Thailand and LS21 from India, with complete growth inhibition at 10(-7) M.
Name Type Language
ARTEMETHER
DASH   HSDB   INN   MART.   MI   ORANGE BOOK   USAN   USP-RC   USP-RS   VANDF   WHO-DD   WHO-IP  
USAN   INN  
Official Name English
.BETA.-ARTEMETHER
Common Name English
NSC-665970
Code English
GVITHER
Common Name English
(+)-ARTEMETHER
Common Name English
ARTEMETHER [JAN]
Common Name English
COARTEM COMPONENT ARTEMETHER
Brand Name English
SM224
Code English
ARTEMETHER [MART.]
Common Name English
(3R,5aS,6R,8aS,9R,10S,12R,12aR)-10-Methoxy-3,6,9-trimethyldecahydro-3,12-epoxypyrano[4,3-j]-1,2-benzodioxepine
Common Name English
ARTEMETHERUM [WHO-IP LATIN]
Common Name English
MALARTEM
Common Name English
NSC-759820
Code English
(3R,5AS,6R,8AS,9R,10S,12R,12AR)-DECAHYDRO-10-METHOXY-3,6,9-TRIMETHYL-3,12-EPOXY-12H-PYRANO(4,3-J)-1,2-BENZODIOXEPIN
Systematic Name English
ARTEMETHER [HSDB]
Common Name English
ARTESAPH
Common Name English
LARITHER
Common Name English
ARTEMETHER [USAN]
Common Name English
FALCIDOL
Common Name English
PALUTHER
Common Name English
3,12-EPOXY-12H-PYRANO(4,3-J)-1,2-BENZODIOXEPIN, DECAHYDRO-10-METHOXY-3,6,9-TRIMETHYL-, (3R,5AS,6R,8AS,9R,10S,12R,12AR)-
Common Name English
ARTEMETHER [USP-RS]
Common Name English
Artemether [WHO-DD]
Common Name English
artemether [INN]
Common Name English
.BETA.-DIHYDROARTEMISININ METHYL ETHER
Common Name English
ARTEMETHER [MI]
Common Name English
ARTEMETHER [VANDF]
Common Name English
ARTEMETHER [WHO-IP]
Common Name English
ARTEMETHER COMPONENT OF COARTEM
Brand Name English
ARTEMETHER [ORANGE BOOK]
Common Name English
Classification Tree Code System Code
WHO-ATC P01BF01
Created by admin on Fri Dec 15 15:40:12 GMT 2023 , Edited by admin on Fri Dec 15 15:40:12 GMT 2023
WHO-ESSENTIAL MEDICINES LIST 6.5.3.1
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NDF-RT N0000175482
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FDA ORPHAN DRUG 245507
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WHO-ATC P01BE02
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WHO-ESSENTIAL MEDICINES LIST 6.5.3.1 (ART/LUM)
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EU-Orphan Drug EU/3/09/702
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NCI_THESAURUS C271
Created by admin on Fri Dec 15 15:40:12 GMT 2023 , Edited by admin on Fri Dec 15 15:40:12 GMT 2023
Code System Code Type Description
FDA UNII
C7D6T3H22J
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PRIMARY
WIKIPEDIA
ARTEMETHER
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PRIMARY
PUBCHEM
68911
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PRIMARY
ChEMBL
CHEMBL566534
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PRIMARY
MESH
C032942
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PRIMARY
NSC
665970
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PRIMARY
RXCUI
18343
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PRIMARY RxNorm
LACTMED
Artemether and Lumefantrine
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PRIMARY
EVMPD
SUB05574MIG
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PRIMARY
CHEBI
195280
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PRIMARY
DAILYMED
C7D6T3H22J
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PRIMARY
RS_ITEM_NUM
1042780
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PRIMARY
MERCK INDEX
m2075
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PRIMARY Merck Index
NCI_THESAURUS
C73001
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PRIMARY
EPA CompTox
DTXSID7040651
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DRUG BANK
DB06697
Created by admin on Fri Dec 15 15:40:12 GMT 2023 , Edited by admin on Fri Dec 15 15:40:12 GMT 2023
PRIMARY
HSDB
7456
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PRIMARY
WHO INTERNATIONAL PHARMACOPEIA
ARTEMETHER
Created by admin on Fri Dec 15 15:40:12 GMT 2023 , Edited by admin on Fri Dec 15 15:40:12 GMT 2023
PRIMARY Description: White crystals or a white, crystalline powder. Solubility: Practically insoluble in water; very soluble in dichloromethane R and acetone R; freely soluble in ethyl acetate R and dehydrated ethanol R. Category: Antimalarial drug. Storage: Artemether should be kept in a tightly closed container and protected from light. Labelling: The designation Artemether for parenteral use indicates that the substance complies with the additional requirements and may be used for parenteral administration. Additional information: The parenteral form is normally intended for intramuscular administration. Requirement: Artemether contains not less than 97.0% and not more than the equivalent of 102.0% of C16H26O5 using ?Assay?, method A, andnot less than 98.0% and not more than the equivalent of 102.0% of C16H26O5 using ?Assay?, method B, both calculated with reference to the dried substance.
NSC
759820
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PRIMARY
USAN
UU-173
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PRIMARY
INN
6458
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PRIMARY
SMS_ID
100000092762
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PRIMARY
DRUG CENTRAL
245
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PRIMARY
CAS
71963-77-4
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