Artesun Dosage/Direction for Use

Dose: Adults and children weighing 20 kg or more: Artesun is administered at a dose of 2.4 mg of artesunate/kg body weight, by intravenous (IV) or intramuscular (IM) injection, at 0, 12 and 24 hours, then once daily until oral treatment can be substituted.
Children weighing less than 20 kg: Artesun is administered at a dose of 3 mg of artesunate/kg body weight, by intravenous (IV) or intramuscular (IM) injection, at 0, 12 and 24 hours, then once daily until oral treatment can be substituted (see Pharmacology: Pharmacodynamics under Actions).
Method of administration: Artesun should be administered for a minimum of at least 24 hours (3 doses), regardless of the patient's ability to tolerate oral medication earlier. After at least 24 hours of Artesun, and when able to tolerate oral medication, the patient should be switched to a complete treatment course of an oral combination antimalarial regimen.
Preparation: Because of the instability of artesunate in aqueous solutions the reconstituted solution must be used within one hour of preparation. Therefore the required dose of artesunate should be calculated and the number of vials of artesunate needed should be determined prior to reconstituting the artesunate powder.
Reconstitution of the artesunate solution: Using a syringe, withdraw the supplied sodium bicarbonate solvent from the ampoule and inject into vial containing the artesunate powder. Shake the vial for several minutes to mix well until the powder is completely dissolved and the solution is clear. If the solution appears cloudy or a precipitate is present, it should be discarded. The reconstituted artesunate solution should always be used immediately, and discarded if not used within one hour.
Following reconstitution the solution must diluted according to the method of injection, as described as follows.
For intravenous (IV) injection: Using a syringe, add the supplied sodium chloride 0.9% for injection solvent to the vial containing the reconstituted artesunate solution. This will yield a solution containing artesunate 10 mg/ml. Shake to mix well, ensuring that the resulting solution is still clear. If the solution appears cloudy or a precipitate is present, it should be discarded.
The volume required will be equal to: (desired dose in mg)/10 ml.
Withdraw the required volume of artesunate solution from the vial with a syringe and then inject slowly intravenously, over 1-2 minutes.
Artesun should NOT be administered as an intravenous drip.
For intramuscular (IM) injection: Using a syringe, add to the vial containing the reconstituted artesunate solution the following volume of the supplied sodium chloride 0.9% for injection solvent: 2 ml for Artesun 60 mg. This will yield a solution containing artesunate 20 mg/ml. Shake to mix well, ensuring that the resulting solution is still clear. If the solution appears cloudy or a precipitate is present, it should be discarded.
The volume required will be equal to: (desired dose in mg)/20 ml.
Withdraw the required volume of artesunate solution from the vial with a syringe and then inject intramuscularly; the anterior thigh is usually the preferred site for injection. If the total volume of solution to be injected intramuscularly is large, it may be preferable to divide the volume and inject it at several sites, e.g. both thighs.
Do not use water for injection for reconstitution of the artesunate powder or for dilution of the resulting solution prior to injection.
Hepatic and renal impairment: Dose adjustment is not necessary in patients with hepatic or renal impairment (see Precautions and Pharmacology: Pharmacokinetics under Actions).