Prescription drugs derived from the Artemisia annua plant show very limited benefit in improving cancer treatment outcomes.

Safety and precautions

At doses used to treat malaria, artemisia-derived drugs are generally safe and well tolerated, but no phase I clinical trials have tested the safety of higher doses that are likely required for treating cancer. Doses used in animal cancer studies have been much higher than those used to treat malaria.

Side effects

The maximum tolerable dose was set at 18 mg/kg due to dose-limiting toxicities observed in dose titration involving people with any type of solid tumor in a phase 1 study.1Deeken JF, Wang H et al. A phase I study of intravenous artesunate in patients with advanced solid tumor malignancies. Cancer Chemotherapy and Pharmacology. 2018 Mar;81(3):587-596.

Use is generally associated with mild side effects

  • Long-term use (up to 37 months) of oral artesunate among metastatic breast cancer patients did not result in any major safety concerns.2von Hagens C, Walter-Sack I et al. Long-term add-on therapy (compassionate use) with oral artesunate in patients with metastatic breast cancer after participating in a phase I study (ARTIC M33/2). Phytomedicine. 2018 Sep 17;54:140-148.
  • Multiple grade 1 or 2 adverse events, but no severe adverse events and no patients dropped out of the study or stopped treatment due to adverse events, among people with cervical intraepithelial neoplasia treated with artesunate intravaginally in an uncontrolled studya study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design.3Trimble CL, Levinson K et al. A first-in-human proof-of-concept trial of intravaginal artesunate to treat cervical intraepithelial neoplasia 2/3 (CIN2/3). Gynecologic Oncology. 2020 Apr;157(1):188-194. 

In their book, Parmar and Kazcor state that use may cause dose-dependent low white counts.4Parmar G, Kaczor T. Textbook of Naturopathic Oncology: A Desktop Guide of Integrative Cancer Care. 1st edition. Medicatrix Holdings Ltd. 2020.

Interactions with other therapies

Liver toxicity has been reported among people using artemisinin-based drugs when combined with oxidative chemotherapies or radiation.5Efferth T. Cancer combination therapies with artemisinin-type drugs. Biochemical Pharmacology. 2017 Sep 1;139:56-70.

Artemisinin-based therapies have shown pharmacokinetic and pharmacodynamic drug interactions with HIV antiviral treatment and treatment failure in some studies with cardiovascular, antibiotic, and antiparasitic drugs.6Hernandez Maldonado J, Grundmann O. Drug-drug interactions of artemisinin-based combination therapies in malaria treatment: a narrative review of the literature. Journal of Clinical Pharmacology. 2022 Oct;62(10):1197-1205.

Do not use (contraindications)

Artemisinin during pregnancy may cause harm to the fetus.7Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010. p. 162.

Consult your pharmacist for interactions, and discuss using artemisinin-based drugs with your doctor. We suggest that patients who use artemisinin derivatives for cancer seek guidance for usage, dose, and formulation from an integrative cancer care clinician or traditional Chinese medicine practitioner with experience working with people with cancer.

Resource

Keep reading about artemisinin-based drugs

Authors

Andrew Jackson, ND

Research Associate
View profile

Andrew Jackson, ND, serves as a CancerChoices research associate. As a naturopathic physician practicing in Kirkland, Washington, he teaches critical evaluation of the medical literture at Bastyr University in Kenmore, Washington. His great appreciation of scientific inquiry and the scientific process has led him to view research with a critical eye.

Andrew Jackson, ND Research Associate

Nancy Hepp, MS

Lead Researcher and Program Manager
View profile

Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher, program manager, and writer for CancerChoices. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher and Program Manager

Reviewer

Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant
View profile

Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, RN, MSN, OCNS Senior Clinical Consultant

Last update: December 15, 2022

Last full literature review: October 2022

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

References[+]