What is the recommended artesunate dose for severe malaria?
For severe malaria, artesunate is given at 2.4 mg/kg as an initial dose by injection, followed by the same dose again at 12 hours, and then once daily thereafter until the patient can take oral treatment [1].
How is artesunate usually given (route and schedule)?
In standard severe-malaria regimens, artesunate is administered intravenously (IV) or intramuscularly (IM) using the same 2.4 mg/kg dosing schedule: 0 hours (first dose), 12 hours, then daily starting the next day [1].
What does “severe malaria” dosing mean for adults vs. children?
The dosing is by body weight (mg/kg), so the same 2.4 mg/kg regimen applies regardless of age, including children, with dosing adjusted to each patient’s weight [1].
When do clinicians switch from injected artesunate to oral treatment?
The injection course continues until the patient can tolerate oral therapy. At that point, clinicians switch to an appropriate oral antimalarial regimen [1].
Are there different dosing regimens for different artesunate formulations?
The regimen described above is the standard severe-malaria dosing (2.4 mg/kg at the specified times). The main difference between products is typically the formulation and preparation, not the weight-based dose schedule [1].
Reference
[1] World Health Organization (WHO). Guidelines for the treatment of malaria, 3rd edition (severe malaria artesunate dosing: 2.4 mg/kg at 0 and 12 hours, then daily; IV/IM). https://www.who.int/publications/i/item/9789241547925