Recommended Dosage for Severe Malaria
Artesunate is given intravenously for severe falciparum malaria in adults and children. The WHO standard regimen starts with 2.4 mg/kg body weight at 0, 12, and 24 hours, followed by 1.2 mg/kg daily until the patient can switch to oral therapy, typically for a total of 7 days.[1]
Dosage Adjustments for Children
Children follow the same mg/kg schedule as adults—no weight-based caps apply. For example, a 20 kg child receives 48 mg (2.4 mg/kg) per initial dose.[1]
How Long Does Treatment Last?
IV artesunate continues until oral artemisinin-based combination therapy (ACT) is tolerated, usually after 24-48 hours. Full course completes with oral ACT like artemether-lumefantrine to prevent resistance.[1]
What If a Dose Is Missed?
Administer the missed dose as soon as possible, then resume the schedule. Do not double up.[1]
Dosage for Non-Severe Malaria
Artesunate is not first-line for uncomplicated cases; rectal or oral ACTs are preferred. If used rectally in emergencies (e.g., children <6 kg), it's 10 mg/kg initially, repeated after 12-24 hours if needed.[1]
Side Effects Patients Report
Common issues include delayed hemolysis (up to 3 weeks post-treatment), anemia, and mild injection-site pain. Monitor hemoglobin weekly after discharge.[1][2]
Availability and Administration
Supplied as 60 mg vials for IV use after reconstitution. Not FDA-approved for all uses but available via CDC for U.S. severe malaria cases.[2]
[1]: WHO Guidelines for Malaria Treatment
[2]: CDC Artesunate Dosing