African Journal of Pharmacy and Pharmacology Vol. 6(9), pp. 636-642, 8 March, 2012
Available online at http://www.academicjournals.org/AJPP
DOI: 10.5897/AJPP11.841
ISSN 1996-0816 ©2012 Academic Journals
Full Length Research Paper
Quality survey of some brands of artesunate-
amodiaquine in Lagos drug market
Teddy Ehianeta, Bidemi Williams, Jadesola Surakat, Nura Mohammed and
Chimezie Anyakora*
Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Lagos, Lagos, Nigeria.
Accepted 8 February, 2012
With the advent of Artemisinin Combination Therapy (ACTs) as the recommended treatment protocol
for malaria by WHO, the menace of substandard and counterfeit anti-malaria drugs have been on the
rise. Artesunate-amodiaquine, like other ACTs, has been widely implicated in this menace due to the
market value and affordability. 13 representative brands of Artesunate/Amodiaquine were procured
from different outlets in urban and peri-urban parts of Lagos, Nigeria. Quantitative and qualitative
analysis were carried out on the different brands using HPLC. The results show all brands to contain
the test APIs but in proportions varied about the USP specified limits. 30.8% of the test brands had
artesunate within the USP specification. 30.8% of amodiaquine also had met the quality specification of
USP. But only 15.4% of the sample had both amodiaquine and artesunate within the USP specification.
53.8% failed the active content test for both amodiaquine and artesunate.
Key words: Artemisinin combination therapy (ACTs), WHO, malaria, high-performance liquid chromatography
(HPLC).
INTRODUCTION
Statistics have shown that malaria is the fifth leading
cause of death worldwide, with 3.3 billion people at risk
(World malaria report, 2010). Several centuries after its
discovery, malaria remains a devastating human
infection, totaling 300 to 500 million clinical cases and
three million deaths every year (World Malaria Report,
2010), but many of these death would be avoided if anti-
malaria drugs were effective (Bate et al., 2009). Since
2001, the World Health Organization has recommended
that malaria-endemic African countries should consider
changing to artemisinin derivative- based combination
therapy (ACT) as first-line malaria treatment. Malaria is
presently endemic in a broad band around the equator, in
areas of the Americas, many parts of Asia, and much of
Africa; however, it is in sub-Saharan Africa where 85 to
90% of malaria fatalities occur (Layne, 2006). The
geographic distribution of malaria within large regions is
complex, and malaria-afflicted and malaria-free areas are
often found close to each other (Greenwood et al., 2002).
*Corresponding author. E-mail: canyakora@gmail.com.
ACTs have been largely successful in combating malarial
in Africa. Successful drugs such as ACTs are at risk of
being counterfeited or produced with insufficient quality
control resulting in substandard products. Since more
than 40% of the world's population is at risk of malaria,
antimalarial drugs have become a favorite target of
counterfeiters. For instance, counterfeit artemisinins are a
significant problem in Southeast Asia (Singh, 2004) and
are expected to become a serious problem in Africa
where artemisinin combination therapy is being
implemented (Dondorp et al., 2010). It has been
estimated that the counterfeit medicine market is worth
some US$ 35 to 44 billion per year (Newton et al., 2006).
Hence, the need for an effective post-marketing
surveillance of all medications especially those used in
treating priority disease. Post Marketing Surveillance
(PMS) is the practice of monitoring a pharmaceutical drug
or device after it has been released on the market.
These substandard products contain active pharma-
ceutical ingredients below or above the range recom-
mended by the USP. A lower dose than the labeled dose
of the active medicament leads to a delivery of lower
concentration to the blood plasma. This consequently