📋 Indications & Clinical Dosage
*Severe malaria including cerebral malaria and as a second line treatment in chloroquine-resistant falciparum malaria:*
BY IM INJ OR IV INF: Adults: First dose 120 mg; followed by 60 mg after 4-6 hr; then 60 mg after every 24 hr once daily. The total duration of treatment is 5 consecutive days. Total doses are 360-480 mg for adults.
Children below 7 yr age: 1.5 mg/kg; 7 yrs or above, same as adult dose. Both the age group children should be given the second dose after 4-6 hr; then one dose after every 24 hr once daily. The total duration of treatment is 5 consecutive days.
💊 Mode of Administration
Deep IM injection or slow IV infusion. Dissolve 60 mg of Artesunate with 1 ml of 5% sodium bicarbonate solution for injection before use in IM injection. Dissolve 60 mg of Artesunate with 1 ml of 5% sodium bicarbonate solution for IV infusion and add 5 ml of 0.9% sodium chloride solution for injection before use to make 1 ml containing 10 mg of Artesunate. Injection must follow immediately soon after dissolution, if the solution appears cloudy or sediment occur, it should be rejected.
⛔ Contraindications
Family history of congenital QT interval prolongation family history of sudden death.
history of arrhythmias. history of clinically relevant
bradycardia .history of congestive heart failure
accompanied by reduced left ventricular ejection fraction Electrolyte disturbances, concomitant use with other drugs known to cause QT-interval prolongation.
⚠️ Precautions & Warnings
Avoid in acute porphyrias, history of arrhythmias, electrolyte disturbances, bradycardia, congestive heart failure accompanied by reduce ventricular ejection fraction; family history of sudden death or of congenital QT interval prolongation.
🔄 Drug Interactions
Antioxidant drugs e.g. vitamin E, C. Additive Chloroquine, antagonistic effect seen with pyrimethamine and sulphonamides
⚠️ Adverse Reactions / Side Effects
Transient and reversible reticulocytopenia, drug fever, drug rash, bradycardia, transient first degree heart block and transient & reversible elevation of serum transaminases, nausea, abdominal pain, diarrhoea, headache.
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated in pregnancy.
Lactation / Breastfeeding:
Caution advised or effect undetermined.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.