Clinical medicine profile
Dihydroartemisinin
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.
Adult: 120mg in the first day, then 60mg OD x 4/7 or 6/7. 11-15yrs: 90mg stat then 45mg OD 4/7 or 6/7, 7-10yrs: 60mg stat, then 30mg OD 4/7 or 6/7 [max. 240mg], 4-6yrs: 40mg stat, then 20mg OD x 4/7 or 6/7 [max. 160mg], 1-3yrs: 30mg stat, then 15mg OD x 4/7 or 6/7 [max. 120mg], less than 1yr: 20mg stat, then 10mg OD x 4/7 or 6/7.
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
- All forms of malaria, including se-vere malaria, cerebral malaria and multi-drug resistant malaria.
- Clinical selection for Dihydroartemisinin should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Antimalarial.
- Confirm site-specific dose, duration and monitoring before prescribing.
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
Artemisinin derivatives are concentrated in the parasitized erythrocytes and it is believed that iron from ingested haemoglobin of the parasite’s victim reduces “Endoperoxide Bridge” releasing a highly reactive free radical iron [IV] oxo species that rips apart the parasitic cells.
Read complete mechanism
Artemisinin derivatives are concentrated in the parasitized erythrocytes and it is believed that iron from ingested haemoglobin of the parasite’s victim reduces “Endoperoxide Bridge” releasing a highly reactive free radical iron [IV] oxo species that rips apart the parasitic cells.
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 |
|---|---|---|---|
| ARH-A | Afya Index / Retail Reference | tabs 6's | KES 340.00afya_index_book |
| Artesiane | Afya Index / Retail Reference | tabs 10's | KES 1,170.00afya_index_book |
| B.Artemisinin Based Combined Formulations | Afya Index product / manufacturer unverified | inj 80mg 6's | Unavailable |
| Gvither | Afya Index / Retail Reference | tabs 1x 10's | KES 250.00afya_index_book |
| Larither | Afya Index / Retail Reference | tabs 60mg 8's | KES 308.00afya_index_book |
| Malgo | Afya Index / Retail Reference | mg/ 320mg 9's | KES 443.00afya_index_book |
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.