# \[e-drug\] Counterfeit artesunate antimalarial tablets **URL:** \ **Category:** e-drug\ **Created:** [June 10, 2003, 11:45am UTC](https://talk.edrugplus.org/t/e-drug-counterfeit-artesunate-antimalarial-tablets/16965 "2003-06-10T11:45:21Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![newtonpaul100](https://avatars.discourse-cdn.com/v4/letter/n/7ba0ec/32.png) [@newtonpaul100](https://talk.edrugplus.org/u/newtonpaul100)\ **Post date:** [June 10, 2003, 11:45am UTC](https://talk.edrugplus.org/t/e-drug-counterfeit-artesunate-antimalarial-tablets/16965/1 "2003-06-10T11:45:21Z")
E-drug: Counterfeit artesunate antimalarial tablets ------------------------------------------------------------------------- Dear Colleagues, Re: Second and third 'generation' fake Guilin Pharma 'artesunate' tablets In the late 1990s counterfeits of artesunate, a vital life-saving antimalarial drug, were discovered circulating in SE Asia. Up to 38% of 'artesunate', labelled as manufactured by Guilin Pharma, People's Republic of China, bought in pharmacies and shops in mainland SE Asia contained no detectable artesunate. This has led to an unquantified but inevitability high mortality and morbidity amongst falciparum malaria patients in the region. The fakes described in 2001 were relatively easy to distinguish from the genuine product by the appearance of the packaging and holograms. A simple, inexpensive dye test allows one to reliably check the authenticity of artesunate tablets. We are now writing to warn of two further sophisticated 'generations' of counterfeit 'artesunate', labelled as produced by Guilin Pharma, bought in Laos and Cambodia with new, convincing and very well crafted but fake holograms attached to the blisterpack. 'Pdf' files of documents warning of the recent discovery of sophisticated counterfeit artesunate, with photographs of the different holograms, and a description of the Fast-Red dye test, are available from newtonpaul100@yahoo.co.uk or newtonpaul100@hotmail.com. Pictures of the genuine and fake holograms are also posted on the Shoklo Malaria Research Unit website (www.shoklo-org.com). The first generation fake 'hologram', described in 2000, is not a true hologram but a sticker and easy to distinguish from the genuine hologram. This is still in circulation. The second generation hologram is a true hologram and only appears to differ from the genuine hologram in the shape of mountain outline and the lack of the microscopic legend 'Guilin Pharma' printed below the 'waves'. The printing on the blisterpack is not clear. Three blisterpacks were recently bought in southern Laos and one in NE Cambodia with this second generation hologram. All have the same code, and manufacture and expiry dates (details in pdf file). It is likely however that artesunate with this second generation fake hologram has or will be made with different dates and codes. The third generation hologram has a mountain outline similar to the genuine Guilin product but lacks the microscopic legend 'Guilin Pharma' printed below the 'waves'. The printing on the blisterpack is crisp and similar to that on the genuine product. Two blisterpacks bearing this new hologram were recently bought in southern Laos (for printed codes and dates see pdf file). All six artesunate blisterpacks with the 2nd and 3rd generation fake holograms were negative for artesunate by the Fast Red Dye Test and contained no artesunate on HPLC analysis. We fear that fake artesunate with the new sophisticated second and third generation fake holograms are widely distributed but, because of their similarity to the genuine product, that they are unrecognised by pharmacists, health staff and patients. Please disseminate this information. If you find any similar fake artesunate we would be very grateful for the information - so that we can map the distribution. We have heard that Guilin Pharma artesunate is now sold in some west African countries, such as Togo, and we are concerned that fakes may also be circulating. We would be very grateful for information on this. There is an urgent need for action and we hope that this information might prompt action to combat this under recognised serious public health problem. Please contact us if you need any further information. Very best wishes, Paul Newton Arjen Dondorp Michael Green Shunmay Yeung Nicholas J White References: 1. Rozendaal J. Fake antimalarials circulating in Cambodia. Bull Mekong Malaria Forum 2000; 7: 62-68. 2. Newton PN, Proux S, Green M, Smithuis F, Rozendaal J, Prakongpan S, Chotivanich K, Mayxay M, Looareesuwan S, Farrar J, Nosten F,White NJ. Fake artesunate in southeast Asia. Lancet 2001; 357: 1948-1950. 3. Green MD, Mount DL, Wirtz RA. Authentication of artemether, artesunate and dihydroartemisinin antimalarial tablets using a simple colorimetric method. Trop. Med. Int. Health 2001; 6: 980 - 982. -- To send a message to E-Drug, write to: e-drug@healthnet.org To subscribe or unsubscribe, write to: majordomo@healthnet.org in the body of the message type: subscribe e-drug OR unsubscribe e-drug To contact a person, send a message to: e-drug-help@healthnet.org Information and archives: [http://www.essentialdrugs.org/edrug](http://www.essentialdrugs.org/edrug)