Indications
Artesunate is an antimalarial medicine. As an injection it is the first choice for treating severe malaria, including severe falciparum malaria, in adults and children. Oral or rectal forms are used in some settings, usually combined with another antimalarial (artemisinin-based combination therapy) to treat uncomplicated malaria, or as pre-referral treatment while transferring a patient to hospital.
How It Works
Artesunate is a derivative of artemisinin, which comes from the sweet wormwood plant. Inside the body it is quickly converted to its active form, which produces reactive molecules that damage the malaria parasites living inside red blood cells. It kills parasites very fast, which helps reduce deaths from severe malaria.
Dosage and Administration
Injectable artesunate is given into a vein or muscle by a doctor or nurse, at a dose based on body weight and repeated at set times, followed by a full course of an oral combination antimalarial once the patient can swallow. Oral and rectal forms are used only as prescribed and must not be used alone as a single medicine for routine treatment.
Interactions
- Strong enzyme inducers such as Rifampicin, Carbamazepine and Phenytoin may reduce its levels.
- Some HIV medicines such as Ritonavir and Nevirapine may change its levels.
- Tell the doctor about all other antimalarials taken recently.
Contraindications
- Known allergy to artesunate or other artemisinin derivatives.
- For severe malaria, the benefit almost always outweighs the risk; the doctor will decide.
Side Effects
Possible effects include dizziness, nausea, vomiting, loss of appetite, stomach pain, headache and a temporary drop in white blood cells. A delayed form of anaemia (red blood cell breakdown) may appear 1 to 3 weeks after treatment of severe malaria.
Get urgent medical help for signs of a severe allergic reaction, dark or cola-coloured urine, marked paleness, extreme tiredness or shortness of breath in the weeks after treatment, new fever, or reduced alertness.
Pregnancy and Lactation
Severe malaria in pregnancy is life-threatening, and injectable artesunate is recommended in all trimesters. For uncomplicated malaria in early pregnancy the doctor will choose the most suitable medicine following current guidelines. Small amounts may pass into breast milk; breastfeeding is generally continued under medical advice.
Precautions and Warnings
- Always complete a full course of combination treatment to prevent drug resistance and relapse.
- A blood count check about 1 to 4 weeks after treatment of severe malaria is often advised.
- Use bed nets and other measures to prevent new mosquito bites.
Overdose
Overdose may increase effects on the blood and nervous system. Treatment is supportive in hospital.
Therapeutic Class
Antimalarial, artemisinin derivative.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Injections are stored and prepared as directed on the pack and used immediately after mixing.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.