Artesunate Dosage

Medically reviewed by Drugs.com. Last updated on Jun 1, 2023.

Usual Adult Dose for Malaria

2.4 mg/kg IV at 0, 12, and 24 hours, then once a day until patient able to tolerate oral antimalarial therapy

Comments:

• Treatment of severe malaria with this drug should always be followed by a complete course of an appropriate oral antimalarial regimen.
• This drug should be administered with an antimalarial agent active against the hypnozoite liver stage forms of Plasmodium (such as an 8-aminoquinoline drug) to patients with severe malaria due to Plasmodium vivax or P ovale.

Use: For the initial treatment of severe malaria

US CDC Recommendations: 2.4 mg/kg IV at 0, 12, and 24 hours (3 doses total) plus reassessment and follow-on therapy

• Continuation of IV therapy (if needed): 2.4 mg/kg IV once a day for up to 6 more days

Comments:

• Recommended for severe malaria, regardless of infecting species; drug susceptibility not relevant for acute treatment of severe malaria.
• If P vivax or P ovale infections, in addition to this acute treatment, antirelapse treatment required.
• Reassessment and follow-on therapy:
• Parasite density should be reassessed at least 4 hours after the third dose.
• If parasite density 1% or less and patient able to tolerate oral therapy, a complete follow-on oral regimen should be given.
• If parasite density 1% or less and patient unable to tolerate oral therapy, IV therapy should continue for up to 6 more days until patient able to take oral therapy.
• If parasite density exceeds 1%, IV therapy should continue for up to 6 more days until parasite density 1% or less; when parasite density 1% or less, a complete follow-on oral regimen should be given.
• Parasite density should be repeated every 12 to 24 hours until negative.
• Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Malaria

2.4 mg/kg IV at 0, 12, and 24 hours, then once a day until patient able to tolerate oral antimalarial therapy

Comments:

• Treatment of severe malaria with this drug should always be followed by a complete course of an appropriate oral antimalarial regimen.
• This drug should be administered with an antimalarial agent active against the hypnozoite liver stage forms of Plasmodium (such as an 8-aminoquinoline drug) to patients with severe malaria due to P vivax or P ovale.

Use: For the initial treatment of severe malaria

US CDC Recommendations: 2.4 mg/kg IV at 0, 12, and 24 hours (3 doses total) plus reassessment and follow-on therapy

• Continuation of IV therapy (if needed): 2.4 mg/kg IV once a day for up to 6 more days

Comments:

• Recommended for severe malaria, regardless of infecting species; drug susceptibility not relevant for acute treatment of severe malaria.
• If P vivax or P ovale infections, in addition to this acute treatment, antirelapse treatment required.
• Reassessment and follow-on therapy:
• Parasite density should be reassessed at least 4 hours after the third dose.
• If parasite density 1% or less and patient able to tolerate oral therapy, a complete follow-on oral regimen should be given.
• If parasite density 1% or less and patient unable to tolerate oral therapy, IV therapy should continue for up to 6 more days until patient able to take oral therapy.
• If parasite density exceeds 1%, IV therapy should continue for up to 6 more days until parasite density 1% or less; when parasite density 1% or less, a complete follow-on oral regimen should be given.
• Parasite density should be repeated every 12 to 24 hours until negative.
• Current guidelines should be consulted for additional information.

Renal Dose Adjustments

Renal dysfunction: No adjustment recommended.

Liver Dose Adjustments

Liver dysfunction: No adjustment recommended.

Precautions

CONTRAINDICATIONS:
Known serious hypersensitivity to the active component (e.g., anaphylaxis)

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Administer constituted drug IV (through an established IV line or needle) as a slow bolus over 1 to 2 minutes; do not administer via continuous IV infusion.
• Administer this drug with an antimalarial agent active against the hypnozoite liver stage forms of Plasmodium (such as an 8-aminoquinoline drug) to patients with severe malaria due to P vivax or P ovale.
• Always follow this drug with a complete treatment course of an appropriate oral antimalarial regimen.

Storage requirements:

• Vials and sterile diluent: Store in the carton at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). Do not freeze; avoid exposure to heat; protect from light. Do not use beyond the expiration date.
• Constituted solution: Administer within 1.5 hours of constitution with the supplied diluent.

Reconstitution/preparation techniques:

• This drug must be constituted with the supplied diluent before administration.
• The manufacturer product information should be consulted.

General:

• Limitations of Use: This drug does not treat the hypnozoite liver stage forms of Plasmodium; it will not prevent relapses of malaria due to P vivax or P ovale. Coadministration with an antimalarial agent such as an 8-aminoquinoline drug is required for treatment of severe malaria due to P vivax or P ovale.

Monitoring:

• Hematologic: For evidence of hemolytic anemia (for 4 weeks after therapy); a direct antiglobulin test

Patient advice:

• You must complete appropriate oral antimalarial therapy after treatment with this drug; you must take an additional antimalarial agent (e.g., an 8-aminoquinoline drug) during or after treatment with this drug for P vivax/P ovale malaria to prevent relapse.
• You need regular blood tests for 4 weeks after completing this drug to monitor for posttreatment delayed hemolysis.
• Seek immediate medical care if signs/symptoms of hypersensitivity reactions or anaphylaxis occur during or after administration of this drug.
• Inform healthcare provider of a known/suspected pregnancy; if exposed to this drug during pregnancy, report your pregnancy to the safety study that monitors pregnancy outcomes.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer