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Methylene blue + artesunate is a combination therapy investigated for the treatment of uncomplicated and drug-resistant Plasmodium falciparum malaria. Methylene blue is the oldest synthetic antimalarial agent and acts as a redox-active compound that interferes with the parasite's redox metabolism, leading to oxidative stress in parasitized erythrocytes. Artesunate is an artemisinin derivative that exerts its effect by generating reactive oxygen species through endoperoxide cleavage in the presence of iron within infected erythrocytes, resulting in rapid parasite clearance. The combination has been shown to have additive or synergistic effects due to methylene blue’s potentiation of artemisinin activity and pronounced gametocytocidal properties, which may help reduce malaria transmission. Clinical studies have demonstrated efficacy against both asexual parasites and gametocytes but also noted increased gastrointestinal side effects such as vomiting[1][2][3][4].
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