Artesunate Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Consultation with Microbiology/Infectious diseases recommended
Unlicensed drug
Stock is kept in ED (Zone A Clinic Room, Press 2, Tray 1 - under RESTRICTED ANTIMICROBIALS)
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)

Artesunate 60mg vial (Artesun)

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)

Slow intravenous injection ONLY

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

Intramuscular injection

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

Store below 25⁰C

1. Artesun SPC March 2020

3"Guidelines for the Treatment of Malaria : World Health Organisation. Nov 2022

Anti-malarial

BNF

IV Guide Type