INTRAMUSCULAR ARTEMISININ DRUGS

Artesunate can be given intramuscularly at 2.4 mg/kg initially, followed by 1.2 mg/kg 12 hours and 24 hours later, then 1.2 mg/kg daily for 6 days. An oral artemisinin compound can be used once the patient can take oral medication. Alternatively, after a minimum of 3 days of artesunate, patients able to take oral medications can be switched to another antimalarial drug appropriate to the area (e.g., either sulfadoxine/pyrimethamine or mefloquine in areas where those drugs remain effective).

Artemether can be given intramuscularly at 3.2 mg/kg on the first day, followed by 1.6 mg/kg daily for 6 days. An oral artemisinin compound can be used once the patient can take oral medication. Alternatively, after a minimum of 3 days of artesunate, patients able to take oral medications can be switched to another antimalarial drug appropriate to the area (e.g., either sulfadoxine/pyrimethamine or mefloquine in areas where those drugs remain effective).

INTRARECTAL ARTEMISININ DRUGS

Artemisinin suppositories can be given using a 40 mg/kg loading dose, followed by 20 mg/kg at 4, 24, 48, and 72 hours. Patients able to take oral medications can then be switched to an oral artemisinin drug at an appropriate dose or another antimalarial drug appropriate to the area (e.g., either sulfadoxine/pyrimethamine or mefloquine in areas where those drugs remain effective).

Artesunate suppositories can be given using one 200-mg suppository initially, followed by one 200-mg suppository at 12, 24, 36, 48, and 60 hours. Patients able to take oral medications can then be switched to an oral artemisinin drug at an appropriate dose or another antimalarial drug appropriate to the area (e.g., either sulfadoxine/pyrimethamine or mefloquine in areas where those drugs remain effective).

For additional details and recommendations, refer to World Health Organization (2000a, 2000b).



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