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Artesunate: Brands, Price & Uses in Bangladesh
Artesunate is an artemisinin derivative antimalarial agent used for the treatment of malaria caused by Plasmodium falciparum and other Plasmodium species.
About Artesunate
Indications of Artesunate
Artesunate is an artemisinin derivative antimalarial agent used for the treatment of malaria caused by Plasmodium falciparum and other Plasmodium species.
Established / Guideline-Supported Uses
- Severe (complicated) malaria - Intravenous (IV) or intramuscular (IM) Artesunate is the treatment of choice for severe malaria in adults and children, as recommended by the World Health Organization (WHO), and is FDA-approved in the United States for initial treatment of severe malaria.
- Uncomplicated P. falciparum malaria - Oral Artesunate is used only as part of artemisinin-based combination therapy (ACT), combined with a longer-acting partner drug (e.g., amodiaquine, mefloquine, sulfadoxine-pyrimethamine, or pyronaridine). Artesunate must never be used alone (as monotherapy) for uncomplicated malaria, because this promotes resistance.
Follow-on Treatment
After completion of IV/IM Artesunate for severe malaria, a complete course of an oral antimalarial (an ACT, atovaquone-proguanil, or doxycycline/clindamycin plus quinine) is required to complete the cure and prevent recrudescence.
Off-label: Artesunate is used off-label in some specialist settings for severe babesiosis unresponsive to standard therapy.
Dosage & Administration of Artesunate
Artesunate dosing differs by indication and severity. Treatment should always be guided by a physician experienced in malaria management.
Severe (Complicated) Malaria - IV/IM Artesunate
| Population | Dose | Schedule |
|---|---|---|
| Adults and children ≥20 kg | 2.4 mg/kg/dose IV or IM | At 0, 12, and 24 hours, then once daily |
| Infants and children <20 kg | 3 mg/kg/dose IV or IM | At 0, 12, and 24 hours, then once daily |
Give a minimum of 24 hours of parenteral Artesunate (at least 3 doses), even if the patient can tolerate oral medication earlier. Continue once-daily parenteral dosing until the patient can reliably take oral therapy, then complete treatment with a full course of an oral antimalarial (an ACT, atovaquone-proguanil, or doxycycline/clindamycin plus quinine).
Uncomplicated P. falciparum Malaria - Oral Artesunate (as part of ACT)
| Population | Dose | Duration |
|---|---|---|
| Adults and children | Approximately 4 mg/kg once daily, combined with a partner drug per the specific ACT regimen prescribed | 3 days |
Artesunate must never be given alone for uncomplicated malaria; it must always be combined with a partner antimalarial as directed by the prescriber.
Renal/Hepatic Impairment
No formal dose adjustment has been established for renal or hepatic impairment; however, such patients should be monitored closely, as severe malaria itself frequently causes acute kidney and liver dysfunction (see Use in Special Populations).
Side Effects of Artesunate
Common
- Nausea, vomiting, diarrhea, abdominal pain
- Dizziness, headache
- Injection site pain or reaction (parenteral use)
- Mild, transient elevations in liver enzymes
Serious (Less Common)
- Post-treatment delayed hemolytic anemia - can occur 1 to 4 weeks after treatment of severe malaria with IV Artesunate, sometimes requiring blood transfusion; hemoglobin should be monitored weekly for at least 4 weeks after treatment (see Precautions and Warnings).
- Neutropenia
- Hypersensitivity reactions, including rare anaphylaxis
- QT interval changes (more often attributable to partner drugs used in combination therapy)
Contraindications of Artesunate
Artesunate is contraindicated in patients with a known history of hypersensitivity to Artesunate or to any other artemisinin-class antimalarial (e.g., artemether, artemotil, dihydroartemisinin).
Frequently Asked Questions about Artesunate
What is Artesunate used for?
Artesunate is used to treat malaria. The injectable form is used for severe (complicated) malaria in adults and children, while the oral form is used, always combined with another antimalarial drug, for uncomplicated malaria caused by Plasmodium falciparum.
Can Artesunate be taken alone for malaria?
Injectable Artesunate is used alone to rapidly treat severe malaria, but it is always followed by a complete course of an oral antimalarial. For uncomplicated malaria, oral Artesunate must always be combined with a partner antimalarial drug and should never be used as monotherapy, since this increases the risk of resistance.
What are the most important side effects of Artesunate to watch for?
The most important side effect to watch for is delayed hemolytic anemia, which can occur 1 to 4 weeks after treatment of severe malaria with IV Artesunate. Your doctor will typically check your blood counts weekly for about 4 weeks after treatment. Other effects include nausea, dizziness, and mild liver enzyme changes.
Is Artesunate safe during pregnancy?
Artesunate should be used in pregnancy only if clearly needed, under a physician's guidance. For severe malaria at any stage of pregnancy, including the first trimester, treatment with Artesunate is generally recommended because untreated severe malaria is very dangerous to both mother and baby. For uncomplicated malaria in the first trimester, your doctor may consider alternative options depending on availability and guidelines.
What should I do if I miss a dose or stop treatment early?
Do not stop, skip, or share Artesunate without medical advice. Incomplete treatment can lead to treatment failure and contributes to drug resistance. Contact your physician promptly if you miss a dose or cannot complete the prescribed course.
What should I do in case of an Artesunate overdose?
If an overdose of Artesunate is suspected, seek immediate medical attention or contact emergency services/a poison control center right away. Treatment in a medical facility is supportive, with monitoring of blood counts and liver/kidney function.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.