Infectious Disease Compendium

Artesunate

Dosing

CrCl Formula

"Enrollment requires a telephone call to the CDC Malaria Hotline (Monday through Friday from 8 a.m. to 4:30 p.m. Eastern time, at 770-488-7788; at other times, health care providers may call 770- 488-7100 and ask for a clinician in the CDC Malaria Branch). If approved, the drug will be released by the CDC Drug Service or by one of the 20 CDC quarantine stations located around the country (PubMed)."

4 mg/kg IV qid x 3 d.

CrCl 80-50: no change in dose with renal or hepatic failure.

CrCl 50-10:

CrCl < 10:

Hemodialysis:

Peritoneal dialysis:

Important side effects

Nausea, vomiting, anorexia, and dizziness, neutropenia, anemia, hemolysis, and elevated levels of liver enzymes, have been noted rarely. Two cases of severe allergic reactions to oral artesunate have been reported. Neurotoxicity.

There is also a dose related neutropenia (PubMed), espcially if therapy goes beyond 3 days or higher (6 mg/kg) dose.

Can cause delayed and severe hemolytic anemia.

Important drug interactions

None.

Rants and Screeds

Pearls

Treatment of choice

Use for

Plasmodium, esp severe Falciparum Malaria, better than quinidine.

Don't use for

Class