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Artesunate Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

  • Consultation with Microbiology/Infectious diseases recommended 
  • Unlicensed drug
  • Stock is kept in ED (top shelf in antibiotic press)
  • In severe malaria it is important to avoid delay and to start treatment with either IV quinine or IV artesunate as soon as possible (within one hour of assessment)

Available preparations

Artesunate 60mg vial (Artesun)

Reconstitution

  • Add 1ml Sodium Bicarbonate 5% diluent (provided in box) to the powder for injection
  • Shake the vial for several minutes until the solution becomes clear - if the solution is cloudy, or a precipitate is present, it should be discarded - this reconstituted solution must be used within one hour of preparation
  • For intravenous use following reconstitution, further dilute with 5ml of Sodium chloride 0.9% (provided in box) and mix well, ensuring that the resulting solution is still clear
  • The resulting solution contains artesunate 10mg per ml (60mg in 6ml)

Methods of intravenous administration

Slow intravenous injection ONLY

  • Give required dose over 1 to 2 minutes 

Dose in adults

For patients with clinically severe malaria

  • Give 2.4mg/kg IV at 0, 12, 24 hours, then every 24 hours until oral treatment can be substituted e.g. 168mg in a 70kg patient
  • Give intravenous artesunate for a minimum of 24 hours (three doses), then switch to oral therapy as per GUH guidelines (GAPP app)
  • Dose adjustment is not required in renal or hepatic impairment

Further information

Intramuscular injection

  • May also be given via this route (See SPC in box) - contact Microbiology/Infectious Disease Consultant and Pharmacy for directions

Storage

Store below25°C

References

1. Artesunate SPC January 2015

2. GUH Antimicrobial Prescribing Guidelines  2018

3. "Guidelines for the Treatment of Malaria : World Health Organisation. 3rd edition 2015

 

Therapeutic classification

Anti-malarial