Artesun Use In Pregnancy & Lactation

Pregnancy: Sever malaria is especially hazardous during pregnancy, therefore full dose parenteral artesunate treatment should be administered at any stage of pregnancy without delay. In animal studies, artesunate has been associated with fetal toxicity during the first trimester of pregnancy. Limited clinical experience with the use of artesunate in the first trimester of pregnancy as well as clinical data from pregnant women, predominantly treated with artesunate in the second and third trimester, do not indicate adverse effects of artesunate on pregnancy or on the health of the fetus/newborn child.
In addition, an observational study conducted in 1179 pregnant women with first-trimester falciparum malaria (of which 183 were treated with first line artemisinin derivatives) showed no differences in the risk of miscarriage or major congenital malformation in artemisinin derivatives versus quinine treatment.
Breastfeeding/lactation: Limited information indicates that dihydroartemisinin, the active metabolite of artesunate, is present at low levels in breast milk. The drug levels are not expected to cause any adverse effects in breastfed infants. The amount of drug present in breast milk does not protect the infant from malaria.