From the Guidelines
The recommended dose of intravenous artesunate for a 70 kg man is 2.4 mg/kg per dose, which equals 168 mg per dose, administered at 0,12, and 24 hours, then once daily thereafter until oral therapy can be started, as stated in the most recent guidelines 1. This dosing regimen is based on the treatment of complicated malaria, which requires immediate and effective intervention to prevent high morbidity and mortality. The medication should be reconstituted and administered as a slow intravenous bolus over 1-2 minutes, and the total treatment course should last at least 7 days. After clinical improvement and when the patient can tolerate oral medication, treatment should be completed with a full course of oral artemisinin-based combination therapy (ACT) such as artemether-lumefantrine. Some key points to consider when administering artesunate include:
- Monitoring for signs of post-artesunate delayed haemolysis (PADH), a potential adverse effect associated with artesunate treatment 1.
- Ensuring the patient can tolerate oral medication before switching to an oral ACT.
- Completing the full treatment course to prevent recurrence and reduce the risk of resistance development. It's also important to note that artesunate is effective against all blood stages of Plasmodium species, including drug-resistant strains, making it the first-line treatment for severe malaria worldwide 1.
From the Research
Artesunate Dosing for a 70 kg Man
- The recommended dose of artesunate is typically expressed in terms of milligrams per kilogram of body weight.
- According to the study 2, the intravenous artesunate administration began with 2 x 0.8 mg/kg initially, which would be approximately 112 mg for a 70 kg man.
- The same study 2 also mentions that the intravenous artesunate was given at a dose of 0.8 mg/kg 12 hours later, and then 0.8 mg/kg twice a day for four days, resulting in a total dose of 8.8 mg/kg.
- For a 70 kg man, this would translate to a total dose of approximately 616 mg over the course of treatment.
- Another study 3 investigated the impact of different artesunate doses on clinical and parasitological responses in malaria patients, including doses of 2,4, and 6 mg/kg/day.
- However, none of the studies provide a specific dose recommendation for a 70 kg man, and the dosing regimens varied across the different studies.
Key Considerations
- The dosing regimen for artesunate may vary depending on the specific treatment protocol and the patient's individual needs.
- It is essential to consult with a healthcare professional to determine the appropriate dose and treatment regimen for a patient with malaria.
- The studies 2, 4, 5, 6, 3 provide valuable information on the efficacy and safety of artesunate in treating malaria, but the dosing recommendations should be interpreted in the context of the specific study protocols and patient populations.