1.ARALEN HISTORY
(How was Aralen discovered?)

Aralen is a product of Sanofi-Synthelabo.  

Sanofi-Synthelabo Inc. is the U.S. affiliate of the global pharmaceutical company Sanofi-Aventis.

Sanofi-Aventis group is Number 1 in Europe and Number 3 worldwide in the Pharmaceutical industry. This group is present in more than 100 countries throughout the 5 continents.

Sanofi-Synthelabo's principal area of business is ethical pharmaceuticals. The core therapeutic areas of Sanofi-Synthelabo are cardiovascular disease and thrombosis; diseases of the central nervous system; oncology; and internal medicine.

Note: World-drugs.net sells generic version of Aralen

2.ARALEN FACTS

Aralen contains the active ingredient chloroquine, which is an antimalarial medicine, though it also has uses in treating the autoimmune diseases rheumatoid arthritis and lupus erythematosus.

Aralen works by attacking the parasites once they have entered the red blood cells. It kills the parasites and prevents them from multiplying further.

It is not fully understood how Aralen kills the parasites, but it is thought to work by blocking the action of a chemical that the parasites produce to protect themselves once inside the red blood cells. The parasites inside the red blood cells digest the oxygen carrying pigment haemoglobin that is found in these cells. This divides the haemoglobin into two parts; haem and globin, and the haem part is toxic to the malaria parasite. To prevent it from being damaged by haem, the malaria parasites produce a chemical that converts haem into a compound that is not toxic to them. Aralen blocks the action of this chemical. This causes the levels of the toxic haem to rise, thus killing the malaria parasites. 

3.ABOUT ARALEN MEDICATION

What is Malaria?

Malaria is a disease mostly of tropical and subtropical areas caused by a single-celled parasite and transmitted by mosquitoes. The illness results in recurrent attacks of chills and fever and can be deadly. 

Signs and symptoms of Malaria

A malaria infection is generally characterized by recurrent attacks with the following signs and symptoms:

• Moderate to severe shaking chills
• High fever
• Profuse sweating as body temperature falls
• General feeling of unease and discomfort (malaise)

Other signs and symptoms include:

• Headache
• Nausea
• Vomiting
• Diarrhea

Causes of Malaria

A one-celled parasite, plasmodium, causes malaria. About 170 species of plasmodium exist, but only four cause malaria in humans:

• P. falciparum . This species, predominant in Africa, produces the most severe symptoms and is responsible for most malaria deaths.
• P. vivid . This species, found mostly in tropical areas of Asia, produces less severe symptoms but can remain in the body (liver) and cause relapses for up to three years.
• P. malariae . This species is found in Africa. It can cause typical malaria symptoms but on rare occasions can remain in the bloodstream for years without producing symptoms. In these cases, an infected person may still pass on the parasite to a mosquito or to another person through a blood transfusion.
• P. ovale . This species is mostly found in West Africa. Although rare, it can also cause relapses.

The transmitter (vector) of plasmodium to humans is the female of the anopheles mosquito. When a mosquito bites a person infected with malaria, it ingests male and female versions of plasmodium (gametocytes). The gametocytes unite in the stomach of the mosquito to form a structure called an oocyst. The oocyst takes about a week to mature and then ruptures, sending out thousands of cells called sporozoites to the mosquito's salivary glands.

MALARIA TRANSMISSION CYCLE 

When the mosquito bites another human, it injects the sporozoites into that person's bloodstream. The sporozoites migrate rapidly to that person's liver, where each one develops over the next week or so into a structure housing thousands of cells called merozoites. In some cases of P. vivax or P. ovale infection, these structures can remain inactive in the liver for extended periods of time. Later, reactivation of the parasite's life cycle then causes a relapse.

Upon maturation, the infected liver cells burst, sending the merozoites into the bloodstream, where they invade red blood cells. Within the red blood cells, they reproduce further, developing into trophozoites, another form of plasmodium, and gametocytes — available to be ingested by the next mosquito and thus renew the transmission cycle.

When infected red blood cells burst, the tiny parasites invade even more red blood cells. As each wave of blood cells ruptures — about every 48 to 72 hours depending on the type of plasmodium — the person experiences an attack of chills, fever and sweating. Typically, signs and symptoms begin 10 days to four weeks after the initial mosquito bite, although they can appear as early as eight days or as late as one year later.

In many cases, medication or your immune system eventually helps stop the infection. But in other cases, particularly in children whose immune systems may not yet have adapted to the parasite, complications of the infection may lead to death. In addition, P. falciparum is capable of invading a much greater number of blood cells than are the other types of plasmodium and can be fatal within a few hours of initial red blood cell rupture.

A pregnant woman can transmit the infection to her unborn baby. Malaria also can be transmitted through blood transfusions, especially in Africa. In the United States, steps have been taken to prevent this type of transmission; people who have been in a malaria-endemic area are prohibited from donating blood for a period of time.

Complications of Malaria

Most complications of malaria are associated with infection by P. falciparum. Among the complications is extensive destruction of red blood cells, which can result in severe anemia. In addition, if parasite-filled blood cells block small blood vessels to the brain (cerebral malaria), swelling of the brain or brain damage may occur. Other complications may include:

• Breathing problems, at times severe in the form of accumulated fluid in the lungs (pulmonary edema)
• Dehydration
• Liver failure
• Kidney failure
• Rupture of the spleen

If untreated, P. falciparum malaria can be fatal within a matter of hours.

Treatment of Malaria

A malaria infection, particularly with P. falciparum, is a medical emergency in the United States and the infected person is hospitalized. In most cases, malaria can be effectively treated with one or more of the following medications:

• Chloroquine
• Quinine sulfate
• Hydroxychloroquine
• Combination of sulfadoxine and pyrimethamine
• Mefloquine
• Combination of atovaquone and proguanil
• Doxycycline

Another class of antimalarial drugs, often prescribed in Asia and now in other parts of the world, is derived from artemisinin, a Chinese sweet wormwood extract. Artesunate is an example of an artemisinin derivative.

Halofantrine is sometimes used for treatment of malaria, although it's not marketed in the United States. People who've been taking mefloquine for prevention of malaria and people with heart problems should not take halofantrine, as it can be dangerous and possibly fatal.

Primaquine may be given to fight the dormant liver form of the parasite and prevent relapses. However, the Centers for Disease Control and Prevention (CDC) has warned against taking primaquine if you're pregnant or have a G6PD (glucose-6-phosphate dehydrogenase) deficiency. Don't take primaquine until you've passed a screening test for this deficiency.

Which drug you take and the length of treatment depend on the type of malaria, where you were infected, your age and how sick you were when treatment began. Drugs are given either orally or intravenously, depending on the severity of illness. In some countries, they may be given in suppository form. After treatment, you may feel very weak and tired. It may take a few weeks before you recover completely.

4.ARALEN EFFECTIVENESS
(When is Aralen best taken?)

Aralen is rapidly and almost completely absorbed from the gastrointestinal tract, and only a small proportion of the administered dose of Aralen is found in the stools. Approximately 55% of the drug in the plasma is bound to non-diffusible plasma constituents.

Excretion of Aralen is quite slow, but is increased by acidification of the urine. Aralen is deposited in the tissues in considerable amounts. In animals, from 200 to 700 times the plasma concentration may be found in the liver, spleen, kidney, and lung; leukocytes also concentrates the drug. The brain and spinal cord, in contrast, contain only 10 to 30 times the amount present in plasma. Aralen undergoes appreciable degradation in the body. The main metabolite is desethylchloroquine, which accounts for one fourth of the total material appearing in the urine; bisdesethylchloroquine, a carboxylic acid derivative, and other metabolic products as yet uncharacterized are found in small amounts. Slightly more than half of the urinary drug products can be accounted for as unchanged chloroquine. 

5.ARALEN EFFECTS ON SPECIAL POPULATION
(How do different people react to Aralen?)

Nursing Mothers

Because of the potential for serious adverse reactions in nursing infants from Aralen, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the potential clinical benefit of the drug to the mother.

Geriatric Use

Clinical studies of Aralen did not include sufficient numbers of subject's aged 65 and over to determine whether they respond differently from younger subjects. However, this drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in Aralen dose selection and it may be useful to monitor renal function.

6.ARALEN EFFECTS ON MEDICAL CONDITIONS
(How does Aralen affect your existing condition/ailment?)

Aralen should not be used if you suffer from liver or kidney disease, if you have a history of epilepsy, myasthenia gravis or G6PD deficiency or porphyrias (life long inherited blood diseases which can cause a variety of symptoms, including mental health problems). 

7.OTHER/ALTERNATE USES OF ARALEN
(What else does Aralen treat?)

Aralen may also be prescribed for the treatment of rheumatoid arthritis.

8.ADVERSE/SIDE EFFECTS of ARALEN
(What are the side effects of Aralen?)

Special Senses : Ocular: Irreversible retinal damage in patients receiving long-term or high-dosage 4-aminoquinoline therapy; visual disturbances (blurring of vision and difficulty of focusing or accommodation); nyctalopia; scotomatous vision with field defects of paracentral, pericentral ring types, and typically temporal scotomas, e.g., difficulty in reading with words tending to disappear, seeing half an object, misty vision, and fog before the eyes.

Auditory: Nerve type deafness; tinnitus, reduced hearing in patients with preexisting auditory damage.

Musculoskeletal system: Skeletal muscle myopathy or neuromyopathy leading to progressive weakness and atrophy of proximal muscle groups, which may be associated with mild sensory changes, depression of tendon reflexes and abnormal nerve conduction, have been noted.

Gastrointestinal system: Anorexia, nausea, vomiting, diarrhea, abdominal cramps.

Skin and appendages: Pleomorphic skin eruptions, skin and mucosal pigmentary changes; lichen planus-like eruptions, pruritus, photosensitivity and hair loss and bleaching of hair pigment. 

Hematologic system: Rarely, aplastic anemia, reversible agranulocytosis, thrombocytopenia and neutropenia.

Central Nervous system : Convulsive seizures. Mild and transient headache. Neuropsychiatric changes including psychosis, delirium, personality changes and depression.

Cardiovascular system: Rarely, hypotension, electrocardiographic change (particularly, inversion or depression of the T-wave with widening of the QRS complex), and cardiomyopathy.