Artesunate is a potent artemisinin derivative used in both adults and children for the treatment of malaria. It is indicated for:

• Treatment of severe and complicated malaria caused by Plasmodium falciparum, particularly in regions with multidrug resistance.
• Treatment of uncomplicated malaria in areas where multidrug-resistant Plasmodium falciparum is prevalent.

It is also used in the management of severe (pernicious) malaria and in the treatment of infections caused by Plasmodium falciparum and Plasmodium vivax.

Artesunate is rapidly converted into its active metabolite dihydroartemisinin (DHA). The endoperoxide bridge of DHA reacts with heme iron within malaria parasites, generating reactive free radicals. These free radicals disrupt protein and nucleic acid synthesis across all erythrocytic stages of the parasite. Additionally, they may alkylate essential parasitic proteins such as calcium ATPase and EXP1, leading to parasite death.

It is to be given by oral route. The oral dose of Artesunate tablet can be defined as follows:

For Artesunate 50 mg tablet:

Adults:

• Two Artesunate 50 tablets twice on the first day, then
• one Artesunate 50 tablet twice daily for the next four days (4, 2, 2, 2, 2)

Children:

• 1-3 years: 3 Artesunate 50 tablets for 5 days (1, 1⁄2, 1⁄2, 1⁄2, 1⁄2)
• 4-5 years: 6 Artesunate 50 tablets for 5 days (2, 1, 1, 1, 1)
• 6-12 years: 8 Artesunate 50 tablets for 5 days (3, 2, 1, 1, 1)

For Artesunate 100 mg tablet:

Adults: One Artesunate 100 tablet twice on the first day, then half Artesunate 100 tablet twice daily for the next four days (2, 1, 1, 1, 1)

Children:

• 4-5 years: 3 Artesunate 100 tablets for 5 days (1, 1⁄2, 1⁄2, 1⁄2, 1⁄2)
• 6-12 years: 4 Artesunate 100 tablets for 5 days (11⁄2,1,1⁄2,1⁄2,1⁄2)
• Patients aged more than 12 years: should be given same as adult dose.

Dosage for the prevention of malaria: Two Artesunate 50 tablets (or one Artesunate 100 tablet) as a single dose once a week, from one week before entering a malaria-affected area to four weeks after leaving the area.

Artesunate may interact with other artemisinin derivatives such as artemether and arteether, which may collectively increase the risk of prolongation of PQ and QT intervals. It may also interact with other antimalarial agents including quinine, quinidine, mefloquine, and halofantrine, especially due to their cardiac effects. Additionally, caution is required when used with drugs known to prolong the QT interval, such as erythromycin, terfenadine, astemizole, probucol, procainamide, disopyramide, amiodarone, bretylium, bepridil, sotalol, tricyclic antidepressants, and neuroleptic agents.

Artesunate is contraindicated in patients with known hypersensitivity to artemisinin derivatives or any component of the formulation.

Artesunate is generally well tolerated, and no significant adverse effects have been reported when used at recommended doses.

• Use with caution in patients experiencing severe vomiting
• For severe malaria, intravenous or intramuscular administration is preferred
• Do not use without the advice of a registered physician
• Do not exceed the recommended dose

Antimalarial drug.

Store below 30°C, protected from light and moisture. Keep out of reach of children.