Artesunate

Uses	Malaria
Therapy	Anti-Malarial
Side Effects	Headache, Nausea, Vomiting

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Molecule Description

Artesunate is an antimalarial agent. It is available as a tablet or an injection (intramuscular or intravenous). It is a critical medicine that is used to treat severe and complicated forms of malaria in children and adults.

Uses

Artesunate is useful for the treatment of severe malaria caused by a particular species of the malarial parasite - Plasmodium Falciparum.

Contraindications

When should one not use Artesunate

This medicine is not for patients who are allergic to Artesunate or any of its components.

Side effects

Common side effects of this drug are:

Fever
Dizziness, feeling light-headed, headache, sleeping problems, ringing in the ears
Cough, running nose
Decreased hunger, feeling sick (nausea), altered taste, loose motions
Rashes, itching, redness, skin eruptions, hair loss, muscle pains and disorders, fatigue, generalized discomfort, pain at injection site
Heart problems (with high doses)
Allergic reactions, low blood cell counts, liver and pancreas problems

Precautions and Warnings

Pregnancy

Artesunate is not recommended for use during the first trimester (first three months) of pregnancy as it can cause new growth defects. It can be used in the second and third trimesters (last six months) of pregnancy. As Artesunate is used to certain severe, life-threatening forms of malaria, its use should not be withheld in pregnancy if the mother’s life is in danger.

Breast Feeding

Minimal amount of Artesunate secretes in breast milk. It can be given to breastfeeding mothers, but it is recommended to wait for 6 hours after taking Artesunate before feeding breast milk to the baby.

Driving

It is unknown if Artesunate can affect your ability to drive. You may drive if you feel better clinically (feel well and not sick).

Alcohol

It is advised to limit your alcohol consumption as Artesunate is used to treat some of the severe forms of malaria, and alcohol may interfere with the process of healing. Mild alcohol consumption is allowed in uncomplicated malaria.

Other General Warnings

Talk to your doctor if

You experience the destruction of red blood cells (post-artmesinin hemolytic anemia) after stopping the treatment is rare but important complication.
A patient who has completed the treatment has to be monitored up to 4 weeks after completion. This condition usually occurs in patients who had a high parasite load.

Mode of Action

How Does It Work?

Artesunate penetrates the red blood cells of the body, which contain the malarial parasite and kills the parasite by interfering with an important enzyme needed for its survival. Artesunate acts rapidly and is one of the few antimalarials that is known to kill all the stages of the parasite in the human blood cells.

Interactions

Interactions with other medicines

Artesunate shows enhanced antimalarial action with Mefloquine, Primaquine, and Tetracycline
It has additive effect with Chloroquine
It reduces the impact of Pyrimethamine and Sulfonamides

Interactions with food items

Not much information is available on interactions of Artesunate when taken with food, consult your doctor or pharmacist for further details.

Dosage

Overdose

An unintentional overdose of Artesunate may not be harmful. But high overdose can cause seizures (fits), blood in stools, low blood cell counts, and in some cases, may affect multiple organs. Seek immediate medical attention if you feel uncomfortable.

Missed a Dose

If you are being treated with Artesunate injection, and if you happen to miss the dose, remind your doctor/nurse of the forgotten dose
In case of a tablet, take the missed dose as early as you remember. If your next dose is less than 6 hours away, skip the missed dose, and continue with the next dose as per schedule
Do not take a higher dose or double dose to make up for the missed dose

Frequently Asked Questions (FAQs)

Generally, Artesunate is administered as an injection and is then switched to tablets.For the injection, the required dose needs to be calculated carefully based on the weight of the patient. It is better to discuss with the doctor or the pharmacist about the exact dosage and administer accordingly.The injection is available as a powder in a vial, which is then needed to mix with 1mL of Sodium Bicarbonate solution provided with the package. Wait for some time, like 5-10 minutes.If the injection is to administer intravenously, mix 5mL of 0.9% Sodium Chloride, and shake the 6mL solution vigorously till the solution is clear. Withdraw this solution with a syringe and should be given by slow intravenous injection at a dose of 3-4 mL/min.In the case of intramuscular injection, mix the original 1mL solution with 2mL of 0.9% Sodium Chloride and shake the resulting 3mL solution vigorously till the solution is clear. Then it should be injected into the muscle, preferably in the front part of the thigh. If the volume is large (higher dose), the amount of injection can be divided among two legs.Do not use water to mix with the powder. Use the mixed (reconstituted) solution within 1 hour.

Injectable Artesunate is a life-saving medicine that is used to treat severe malaria and is on the essential medicines list of the World Health Organization (WHO). It is also beneficial in traveler’s malaria (malaria in travelers who travel to a region where this is common as compared to where malaria is rare).This medicine is proved to be a safe medicine with relatively low side effects in both children and adults. It is one of the mainstays of treatment of severe malaria (due to Plasmodium falciparum) in countries where it is shared.