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 (ref 1)
  • Unlicensed preparation
  • 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) (ref 1)

Available preparations

Artesun 60mg vial

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 (provided the patient is able to swallow and absorb medication) as per GUH guidelines (ref 1))
  • Dose adjustment is not required in renal or hepatic impairment

Monitoring

  • Monitor blood pressure, heart rate, respiratory rate, signs of hypersensitivity and haemoglobin levels (ref 2)
  • Monitor patients for 4 weeks after treatment for evidence of haemolytic anaemia (ref 2)

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 below 250C

References

Artesun SPC August 2022

1.GUH Antimicrobial Prescribing Guidelines

2. Injectable medicines guide, downloaded 7th Mary 2025

Also available:Guidelines for the Treatment of Malaria : World Health Organisation. Nov 2024

Therapeutic classification

Anti-malarial

BNF
Malaria