Artesunate is a medication used to treat malaria. While it is generally safe and effective, there are some contraindications to its use. According to Medscape [2], artesunate should not be used in patients with a known hypersensitivity to artemisinin or any of the ingredients in the formulation. It should also not be used in patients with severe hepatic or renal impairment, as there is limited information on the use of artesunate in these populations. Additionally, it is not recommended for use in pregnant women unless the potential benefits outweigh the risks, as animal studies have shown embryotoxicity and teratogenicity. The use of artesunate in breastfeeding women is also not recommended, as it is not known whether the drug is excreted in human milk.

Everyday Health [3] notes that artesunate may interact with other medications, including anticoagulants, antiplatelets, and drugs that affect liver enzymes. Patients taking these medications should be monitored closely if they are also taking artesunate.

In summary, while artesunate is generally safe and effective for the treatment of malaria, there are some contraindications to its use. It should not be used in patients with a known hypersensitivity to artemisinin or any of the ingredients in the formulation, or in patients with severe hepatic or renal impairment. Its use in pregnant and breastfeeding women is also not recommended. Patients taking other medications should be monitored closely if they are also taking artesunate.

Sources:
[2] Medscape: https://reference.medscape.com/drug/artesunate-342684
[3] Everyday Health: https://www.everydayhealth.com/drugs/artesunate