Diluent for Intravenous Artesunate
The recommended diluent for intravenous artesunate is 5% dextrose solution. 1
Administration Protocol
Artesunate for intravenous administration requires specific preparation steps:
- Reconstitution: Artesunate powder must be reconstituted before administration
- Diluent: Use 5% dextrose solution as the infusion medium 1
- Dosing: Standard dosing is 2.4 mg/kg IV at 0,12, and 24 hours, then daily until oral therapy can be initiated 1, 2
Important Administration Considerations
- Stability: Artesunate has limited stability at room temperature - approximately 4 hours at 30°C (typical tropical climate temperature) 3
- Light sensitivity: While exposure to light does not significantly affect degradation rate 3, standard practice is to protect reconstituted solutions from light
- Rapid conversion: Artesunate rapidly converts to its active metabolite dihydroartemisinin after administration 4
- Administration method: Can be given as IV bolus or infusion, with infusion potentially providing more sustained therapeutic levels 3
Clinical Context
Artesunate is the preferred first-line treatment for complicated malaria of all Plasmodium species, offering:
- Faster parasite clearance compared to quinine
- Reduced mortality in severe malaria
- Availability in both IV and IM formulations 2
Common Pitfalls to Avoid
- Preparation timing: Artesunate should not be prepared far in advance due to limited stability
- Incorrect diluent: Using solutions other than 5% dextrose may affect drug stability
- Delayed administration: Artesunate should be administered promptly in severe malaria cases as it significantly improves outcomes
- Inadequate monitoring: Patients should be monitored for post-artesunate delayed hemolysis (PADH), particularly at days 7,14,21, and 28 after treatment 2
Artesunate's rapid action makes it ideal for severe malaria treatment, but proper preparation with the correct diluent (5% dextrose) is essential for maintaining drug efficacy and patient safety.