Artemisinin and Artesunate
Also known by these names
Laura Pole, RN, MSN, OCNS, BCCT Senior Researcher
Nancy Hepp, MS, BCCT Project Manager
Last updated August 12, 2021.
The Artemisia annua plant contains chemical compounds effective against malaria and also considered to have anticancer activity. Artemisinin is a natural derivative of Artemisia annua, and artesunate is a prescription medication derived from Artemisia annua. Since artesunate is a prescription drug approved for use in malaria, its use in cancer is considered off-label.
Treating the Cancer
Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action
Artemisinin's anticancer activity is believed to occur when it comes in contact with iron. Cancer cells concentrate iron for use in cellular division (the malaria parasite also collects high concentrations of iron). Artemisinin's contact with iron triggers the release of free radicals between cells that destroy cancer cells. Because of this “ferroptosis” effect, iron is often administered several hours before artemisinin to enhance targeting of the cancer cells while sparing normal cells.
Case studies and preliminary clinical trials have shown some anticancer effects in human patients, but the evidence is not strong or compelling at this point:
- A 2018 review of clinical artesunate and artemisinin derivatives did not find efficacy in the treatment of cervix, breast, colorectal and lung cancers.2
- Colorectal cancer: reduced tumor proliferation (antiproliferative) in a small trial3
- Advanced non small-cell lung cancer: the standard combination of vinorelbine and cisplatin combined with intravenous (IV) artesunate was effective and well tolerated4
- Melanoma: response and regressions of splenic and lung metastases in case studies5
Lab and Animal Evidence
Reducing the risk of developing cancer or the risk of recurrence
Artesunate reduced disease recurrence when used at the time of surgery in a small trial.35
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 studies have been much higher than those used in anti-malaria treatment.
Plant leaves and powdered and liquid extracts are available for purchase in the US. Artemisinin, a natural derivative of Artemisia annua, is available for purchase as a supplement.
Artesunate, the synthetic drug derived from the Artemisia plant, is available by prescription in the US only for patients who have a documented case of severe malaria. It is used widely in European cancer clinics providing complementary therapies.
Exact dosage of the herb Artemisia annua in cancer has not been determined in clinical trials. Concentrations of the active ingredients vary among products.43 See Quality and Sources of Herbs, Supplements and Other Natural Products for general information.
Integrative cancer care plans, protocols and references listed below suggest doses. For a lengthy discussion of dosages of the various plant and supplement derivatives of Artemisia annua, artemisinin and artesunate, see these sources:
- Mihaela Catalina Stanciu Foundation for Life website: Artemisia annua, Artemisinin, & 2015 Nobel Prize in Medicine.
- The Moss Reports (requires purchase)
- Natural Medicines Database (requires purchase)
Integrative Programs, Protocols and Medical Systems
|For more information about programs and protocols, see our Integrative Programs and Protocols page.|
A number of European complementary and alternative medicine cancer clinics use this natural product, and Chinese researchers consider it a very promising anticancer therapy.
- Programs and protocols
- Alschuler & Gazella complementary approaches:44
- Bastyr University Integrative Oncology Research Center protocol for Stage IV Breast Cancer45
- Chang strategies46
- MacDonald breast cancer program47
- McKinney protocols48
- General cancer
- Breast cancer
- Carcinoid/neuroendocrine cancer
- Cervical cancer
- Colorectal cancer
- Esophageal cancer
- Gallbladder cancer
- Head and neck cancer
- Kidney cancer
- Liver cancer
- Lung cancer
- Multiple myeloma
- Myelodysplastic syndrome
- Ovarian cancer
- Pancreatic cancer
- Prostate cancer
- Stomach cancers
- Used in the Parmar & Kazcor treatment plans49
- Traditional systems
Non-cancer Uses of Artemisinin
BCCT has not reviewed the effectiveness of this therapy for non-cancer uses.
- Memorial Sloan Kettering Cancer Center’s About Herbs: Artemisia annua
- CAM-Cancer: Artemisia
- Mihaela Catalina Stanciu Foundation for Life: Artemisia annua, Artemisinin & 2015 Nobel Prize in Medicine
- Chang R. Beyond the Magic Bullet: The Anti-Cancer Cocktail. New York: Square One Publishers. 2012.
- TRC Natural Medicines: Artemisinin Herba-Alba and Sweet Annie (subscription required): in-depth information, ratings of effectiveness and safety and evaluation of specific Artemisia products
- Consumer Labs: Product Review (subscription is required): Wormwood
- Moss Reports podcast: Repurposed Drugs for Cancer with Raymond Chang, MD
- Gurdev Parmar and Tina Kaczor: Textbook of Naturopathic Oncology
- Barbara MacDonald, ND, LAc: The Breast Cancer Companion: A Complementary Care Manual: Third Edition
- Dwight McKee, MD, editor: Clinical Pearls
- Donald I. Abrams, MD, and Andrew T. Weil, MD: Integrative Oncology, 2nd Edition
- Neil McKinney, BSc, ND: Naturopathic Oncology, 3rd Edition
- Lise Alschuler, ND, FABNO, and Karolyn Gazella: The Definitive Guide to Cancer, 3rd Edition
- Keith I. Block, MD: Life over Cancer: The Block Center Program for Integrative Cancer Treatment
- American Botanical Council: HerbMed
- Lone Star Medical Group: Natural Alternative Treatments