📋 Indications & Clinical Dosage
*Severe malaria including cerebral malaria and as a second-line treatment in chloroquine resistant falciparum malaria:*
BY IM 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.
BY IM OR IV INF: Children age 7 yrs or more: same as adult dose. Below 7 yrs age: 1.5 mg/kg. Both the age group children should be given the sec 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 IM injection before use. 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 mlcontaining 10 mg of Artesunate. Injection must follow immediately soon after dissolution, if the solution appears cloudy or sediment occurs, it should be rejected.
⛔ Contraindications
Family history of suddendeath, electrolyte disturbances, concomitant use with other drugs known to cause QT-interval prolongation.
⚠️ Precautions & Warnings
Congestive heart failure accompanied by reduced ventricular ejection fraction, history of arrhythmias, bradycardia, history of congenital QT interval prolongation
🔄 Drug Interactions
Antioxidant drugs e.g. vitamin E, C. Additive effect seen with chloroquine, antagonistic effect seen with pyrimethamine and sulphonamides
⚠️ Adverse Reactions / Side Effects
Abdominal pain, diarrhoea, headache, fever, rash, nausea, transient and reversible reticulocytopenia, bradycardia, transient first degree heart block and transient & reversible elevation of serum transaminases
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated
Lactation / Breastfeeding:
Caution advised
📚 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.