Toxicity associated with repeated administration of artemether-lumefantrine in rats

Environ Toxicol. 2015 Mar;30(3):301-7. doi: 10.1002/tox.21907. Epub 2013 Sep 25.

Abstract

Chemotherapy remains an important approach in the fight against malaria. Artemether-lumefantrine combination is widely in use due to its effectiveness against Plasmodium falciparum. Misuse in the form of multiple repeated doses of this anti-malaria drug is rampant in Nigeria. This study was designed to assess the hepatotoxic and clastogenic potential of extreme misuse of artemether-lumefantrine in rats. Graded doses of artemether-lumefantrine (1-5 mg/kg body weight) were administered by oral gavage for 6 weeks, twice daily, for 3 consecutive days per week. Artemether-lumefantrine, at all doses, did not have significant effects on the body and relative liver weight of treated group compared to the negative control group. The mean γ-glutamyltransferase, alanine, and aspartate aminotransaminase activity in groups of artemether-lumefantrine treated rats were significantly higher (p < 0.05) than that of the negative control group indicating that repeated administration of artemether-lumefantrine may be hepatotoxic. Findings from histological analyses of liver cross-section support the enzyme pattern of hepatoxicity. In addition, the drug, at all experimental doses, significantly induced (p < 0.05) formation of micronucleated polychromatic erythrocytes in the bone marrow cells of the treated rats compared with the negative control indicating clastogenic potential of the drug when misused.

Keywords: anti-malaria; artemether-lumefantrine; drug misuse; drug toxicity; micronucleated polychromatic erythrocytes.

MeSH terms

  • Alanine Transaminase / metabolism
  • Animals
  • Antimalarials / toxicity*
  • Artemether, Lumefantrine Drug Combination
  • Artemisinins / toxicity*
  • Aspartate Aminotransferases / metabolism
  • Body Weight / drug effects
  • Dose-Response Relationship, Drug
  • Drug Combinations
  • Erythrocytes / drug effects
  • Ethanolamines / toxicity*
  • Fluorenes / toxicity*
  • Liver / drug effects
  • Liver / pathology
  • Male
  • Micronucleus Tests
  • Organ Size / drug effects
  • Rats
  • Rats, Wistar
  • gamma-Glutamyltransferase / metabolism

Substances

  • Antimalarials
  • Artemether, Lumefantrine Drug Combination
  • Artemisinins
  • Drug Combinations
  • Ethanolamines
  • Fluorenes
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase