Clinical medicine profile
Artesunate sodium
Antimalarial
- Route
- ORAL / PARENTERAL (severe malaria)
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
This profile needs source confirmation
A traceable source link is not attached to this profile. Confirm prescribing decisions against the current SmPC and Kenya STG/EML.
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Known hypersensitivity.
- Agent-specific: e.g. mefloquine in active depression/psychosis/seizure disorder
- primaquine in G6PD deficiency (haemolysis).
- Always check agent-specific absolute contraindications.
Precautions
- Confirm species and severity.
- ECG risk with some agents (quinine, piperaquine).
- Pregnancy: follow Kenya/WHO trimester-specific ACT guidance.
- Vomiting within 30–60 min may need redosing per protocol.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
2.4 mg/kg body weight IV or IM given on admission [time = 0], then at 12 h and 24 h, then once a day. Artesunate reconstituition: Step 1: The powder for injection should be reconstituted with 1mL of 5% sodium bicarbonate and shaken vigorously till the solution becomes clear. Step 2: For I.V. use, add 5 mL [2mL for I.M. use] of normal saline or 5% of glucose and mix again. Step 3: For I.V. use, the required amount of the drug is administered slowly over a period of 2 - 3 minutes. The powder for injection is difficult to dissolve and care should be taken to ensure that it is completely dissolved before parenteral administration. It should always be used immediately after reconstitution. If the solution is cloudy or a precipitate is present, the parenteral preparation should be discarded.
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Supportive care critical in severe malaria; adjust supportive drugs as needed.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Monitor if pre-existing liver disease; many agents hepatically metabolised.
Use, effects & interactions
Indications
- Therapeutic use is agent- and indication-specific within the class (Antimalarial).
- Use according to culture results, national guidelines (Kenya STG/EML where applicable) and the current product SmPC.
- See under artemether.
Adverse effects
- GI upset, headache, dizziness, sleep disturbance (mefloquine).
- Serious: cardiotoxicity, neuropsychiatric effects, haemolysis (primaquine in G6PD def.), cinchonism (quinine).
Drug interactions
Open multi-drug checker ↗- Kenya: follow current MoH malaria guidelines for uncomplicated vs severe disease.
- Test before treat when feasible.
- Complete full ACT course.
- Severe malaria is an emergency — parenteral artesunate, not oral therapy alone.
Mechanism & disposition
Artemisinins generate carbon-centred free radicals after activation by parasite haem-iron, damaging parasite proteins and membranes — rapid blood schizonticidal effect.
Read complete mechanism
Artemisinins generate carbon-centred free radicals after activation by parasite haem-iron, damaging parasite proteins and membranes — rapid blood schizonticidal effect. Partner drugs (lumefantrine, piperaquine, etc.) provide longer-acting clearance of residual parasites. Other classes act on haem detoxification, electron transport, or folate pathways depending on agent.
Hours (artemisinins rapid parasite clearance)
Regimen-dependent (ACT 3 days typical)
ORAL / PARENTERAL (severe malaria)
enhanced by fat-containing food. Complex
(CYP3A4) for several partners. Severe malaria: parenteral artesunate preferred first-line in most guidelines.
Pregnancy, lactation & diet
Treat malaria — untreated infection risks mother and fetus. Use trimester-appropriate regimens per Kenya MoH / WHO.
Most first-line ACTs compatible; continue breastfeeding with maternal treatment.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| Artecor | Signature | tabs 1's | Unavailable |
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.