Artesunate injection 60mg

Therapeutic action– AntimalarialIndications– Treatment of severe falciparum malaria– Initial treatment of uncomplicated falciparum malaria, when persistent vomiting precludes oral therapyForms and strengths, route of administration– Powder for injection, in 60 mg-vial, with one 1 ml-ampoule of 5% sodium bicarbonate and one 5 mlampoule of 0.9% sodium chloride, for slow IV injection (3 to 5 minutes) or slow IM injection– Dissolve the powder in the entire volume of 5% sodium bicarbonate and shake the vial until the solution becomes clear. Then, add the 0.9% sodium chloride into the vial:5 ml of 0.9% sodium chloride to obtain 6 ml of artesunate solution containing 10 mg/ml, for IV injection2 ml of 0.9% sodium chloride to obtain 3 ml of artesunate solution containing 20 mg/ml, for IM injectionDosage and duration– Child under 20 kg: 3 mg/kg/dose– Child 20 kg and over and adult: 2.4 mg/kg/dose– One dose on admission (H0) then 12 hours after admission (H12) then 24 hours after admission (H24) then, once daily.Administer at least 3 doses parenterally, then, if the patient can tolerate the oral route, change to an artemisinin-based combination (do not use the combination artesunate-mefloquine if the patient developed neurological signs during the acute phase).WeightIV injectionartesunate solution 10 mg/mlIM injectionartesunate solution 20 mg/ml< 3 kg1 ml0.5 ml*3 to < 4 kg1.2 ml0.6 ml*4 to < 5 kg1.5 ml0.8 ml*5 to < 6 kg2 ml1 ml6 to < 8 kg2.5 ml1.2 ml8 to < 10 kg3 ml1.5 ml10 to < 13 kg4 ml2 ml13 to < 15 kg4.5 ml2.5 ml15 to < 17 kg5 ml2.5 ml17 to < 20 kg6 ml3 ml20 to < 25 kg6 ml3 ml25 to < 29 kg**7 ml3.5 ml29 to < 33 kg8 ml4 ml33 to < 37 kg9 ml5 ml37 to < 41 kg10 ml5 ml41 to < 45 kg11 ml6 ml45 to < 50 kg12 ml6 ml50 to < 55 kg**13 ml7 ml55 to < 62 kg15 ml8 ml62 to < 67 kg16 ml8 ml67 to < 71 kg17 ml9 ml71 to < 76 kg18 ml9 ml76 to 81 kg**20 ml10 ml* Use a 1 ml syringe graduated in 0.01 ml when the dose required is less than 1 ml.** For patients over 25 kg, a 2nd vial must be prepared to obtain the volume needed, a 3rd vial for patients over 50 kg and a 4th vial for patients over 76 kg.Contra-indications, adverse effects, precautions– May cause: gastrointestinal disturbances, dizziness, headache, fever, muscle and joint pain, pruritus; rarely rash, QT interval prolongation, post-treatment haemolytic anaemia (especially in case of hyperparasitaemia and in young children).– Pregnancy: no contra-indication– Breast-feeding: no contra-indicationRemarks– The solution should be clear, do not use if the solution is cloudy or if a precipitate is present.– Do not use water for injection for: reconstitution (only use sodium bicarbonate); dilution (only use sodium chloride).– Storage: below 25 °C