VHOSPITAL.CLINIC · Parasite Treatment Drug

Artesunate for Malaria

Intravenous artesunate is the WHO-recommended treatment for severe malaria, replacing quinine as the gold standard due to faster parasite clearance and lower mortality.

AntimalarialArtesunate Full Drug Profile →Drug-first view →

How Artesunate Works Against Malaria

Artesunate is a water-soluble artemisinin derivative that can be given IV/IM. It generates reactive oxygen species inside infected erythrocytes, rapidly clearing high-density parasitaemia and reducing fatal complications.

Dosing Protocol

IV artesunate: 2.4 mg/kg at 0, 12, and 24 hours, then daily. Switch to oral ACT once the patient can tolerate oral medication. Hospitalisation required for severe cases.

This is a general reference. Always follow your physician's prescription and local treatment guidelines.

Side Effects

  • Post-artesunate delayed haemolysis (PADH) — monitor haemoglobin 2–4 weeks post-treatment
  • Transient liver enzyme elevation
  • Cardiac conduction changes at high doses

Red Flags

  • ⚠️Signs of severe malaria: impaired consciousness, respiratory distress, haemoglobinuria
  • ⚠️Parasitaemia >2% on blood film
  • ⚠️Failure to improve within 24 hours
  • ⚠️New haemolysis symptoms 2–4 weeks post-treatment

FAQ: Artesunate and Malaria

Why is artesunate preferred over quinine for severe malaria?

The WHO AQUAMAT trial showed artesunate reduced mortality by 22.5% versus quinine in severe malaria. It also has fewer cardiac side effects and is easier to administer.

What is post-artesunate delayed haemolysis?

PADH is a recognised complication occurring 2–4 weeks after IV artesunate in patients who had high parasitaemia. Haemoglobin can drop significantly. All patients should have a haemoglobin check 4 weeks post-treatment.

Can artesunate be used in children with severe malaria?

Yes. IV artesunate is the treatment of choice for severe malaria in children. Rectal artesunate pre-referral is recommended in settings where IV access is unavailable.

Other Treatments for Malaria

Symptoms Malaria Causes

Artesunate treats Malaria, which can cause these symptoms:

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Medical References

Content on this page is informed by evidence-based clinical sources including: