Artemisia annua                                         Common name: Sweet Annie, Chinese Wormwood

Family: Asteraceae

Part Used: Leaf

Constituents: Sesquiterpene lactones (artemisinin), VO (including alpha-pinene, camphene, ß-pinene (0.882%), myrcene, 1,8-cineole, artemisia ketone, linalool, camphor, borneol, and ß-caryophyllene)m flavonoids

Medicinal actions: Antiparasititc, Antineoplastic, Bitter, reduces fever, Anti-malarial, Highly aromatic

Medicinal uses: Malaria & Parasitic infections (leishmaniasis, Chagas’ disease, African sleeping sickness), Cancer, Fever, Headaches & Dizziness.

Pharmacology:

• Artemisinin is a sesquiterpene lactone with 2 oxygen atoms linked by an endo-peroxide bridge. This readily reacts with iron to form free radicals causing oxidative stress to the cell.
• Has been shown to inhibit protein synthesis by the malarial protozoa Plasmodium falciparum while inhabiting human red blood cells in vitro (note: in cerebral cases parasite clearance from the blood was better with artemisinin than either chloroquine or quinine (common antimalarial medications).

• Preferentially taken up with iron therefore test for iron, ferritin, TIBC
• Up regulation of CYP 2B6, CYP 2C19 and CYP 3A4 → increased hepatic clearance so plasma levels drop off after 5 – 7 days.

Pharmacy: 90-120 gtt of 1:2 QD or 150 mg capsule BID (note: better absorbed through tea vs. capsules), IM or intranasally. Note: Women clear up to twice as fast as me, therefore need to pulse dose to allow enzymes to normalize periodically.

Toxicity: High doses of isolated sesquiterpene lactones are neurotoxic. High oral doses may cause abdominal pain, bradycardia, diarrhea, nausea, vomiting, decreased appetite, flu-like symptoms, fever, liver enzyme elevations and decreased reticulocyte count.

Contraindications: Pregnancy, lactation, seizures

Interactions: Interferes with antacids, sucralfate, proton pump inhibitors, and histamine-receptor antagonists because it increases the production of stomach acid. Can induce seizures resulting in decreased efficacy of anti-seizure medications